Physeal Growth Arrest Caused by Thromboembolism of the Right Femoral Artery in a Premature Infant

Hayong Kim; Jong-Won Kang; Hyun-Jong Park; Jae-Won Lee; Wonsik Choi

doi:10.4055/jkoa.2011.46.4.345

Journal List > J Korean Orthop Assoc > v.46(4) > 1013090

Go to TopGo to Top Go to BottomGo to Bottom

TOOLS

Kim, Kang, Park, Lee, and Choi: Physeal Growth Arrest Caused by Thromboembolism of the Right Femoral Artery in a Premature Infant

Case Report

Journal of the Korean Orthopaedic Association

Journal of the Korean Orthopaedic Association 2011; 46(4): 345-349.

Published online: 31 August 2011

DOI: https://doi.org/10.4055/jkoa.2011.46.4.345

Physeal Growth Arrest Caused by Thromboembolism of the Right Femoral Artery in a Premature Infant

Hayong Kim, M.D., Ph.D., Jong-Won Kang, M.D., Hyun-Jong Park, M.D., Jae-Won Lee, M.D., Wonsik Choi, M.D., Ph.D.

Department of Orthopedic Surgery, Eulji University School of Medicine, Daejeon, Korea.

Correspondence to: Hayong Kim, M.D., Ph.D. Department of Orthopaedic Surgery, Eulji University College of Medicine, 1306, Dunsan-dong, Seo-gu, Daejeon 302-799, Korea. TEL: +82-42-611-3279, FAX: +82-42-259-1289, hykim@eulji.ac.kr

Received 21 March 2011 Accepted 19 May 2011

(open-access):

This is an Open Access article distributed under the terms of the Creative Commons Attribution Non-Commercial License (http://creativecommons.org/licenses/by-nc/3.0/) which permits unrestricted non-commercial use, distribution, and reproduction in any medium, provided the original work is properly cited.

Abstract

The known causes of premature physeal growth arrest are trauma, infection, tumor, antibiotics, radiation and vascular insult. We report here on a premature, very low birth-weight infant who was complicated with premature physeal arrest of the proximal and distal tibial physis after severe limb ischemia due to thromboembolism of the right femoral artery. This case suggests that a severe ischemic state of the lower extremity might cause premature physeal arrest in premature infants.

Keywords: tibia, physeal arrest, thromboembolism, very low birth-weight infant

Figures and Tables

Figure 1

Clinical manifestations due to throboembolism at eight-weeks of age. (A) Colors of the right lower extremity changed to dark purple and black. (B) Femoral artery was obstructed with thromboembolism on Doppler examination.

Figure 2

(A) Right lower extremity was swollen due to compartment syndrome. (B, C) Fasciotomy was done with local anesthesia.

Figure 3

(A, B) Necrotic area was well demarcated after fasciotomy. (C) Split-thickness skin graft was done over the granulation tissue of open amputee stump.

Figure 4

(A, B) Right limb was shorter than left due to the premature physeal arrest of proximal and distal physes of right tibia.

References

1. Martin JA, Kung HC, Mathews TJ, et al. Annual summary of vital statistics: 2006. Pediatrics. 2008. 121:788–801.

2. Merrer J, De Jonghe B, Golliot F, et al. French Catheter Study Group in Intensive Care. Complications of femoral and subclavian venous catheterization in critically ill patients: a randomized controlled trial. JAMA. 2001. 286:700–707.

3. National Institute of Child Health and Development (NICHD). Follow-up care of high-risk infants. Pediatrics. 2004. 114:1377–1397.

4. Mactier H, Alroomi LG, Young DG, Raine PA. Central venous catheterisation in very low birthweight infants. Arch Dis Child. 1986. 61:449–453.

5. O'Neill JA Jr, Neblett WW 3rd, Born ML. Management of major thromboembolic complications of umbilical artery catheters. J Pediatr Surg. 1981. 16:972–978.

6. Aspalter M, Domenig CM, Haumer M, Kitzmüller E, Kretschmer G, Hölzenbein TJ. Management of iatrogenic common femoral artery injuries in pediatric patients using primary vein patch angioplasty. J Pediatr Surg. 2007. 42:1898–1902.

7. Balaguru D, Dilawar M, Ruff P, Radtke WA. Early and late results of thrombolytic therapy using tissue-type plasminogen activator to restore arterial pulse after cardiac catheterization in infants and small children. Am J Cardiol. 2003. 91:908–910.

8. Lin PH, Dodson TF, Bush RL, et al. Surgical intervention for complications caused by femoral artery catheterization in pediatric patients. J Vasc Surg. 2001. 34:1071–1078.

9. Farrar MJ, Bennet GC, Wilson NI, Azmy A. The orthopaedic implications of peripheral limb ischaemia in infants and children. J Bone Joint Surg Br. 1996. 78:930–933.

10. Peterson HA. Premature physeal arrest of the distal tibia associated with temporary arterial insufficiency. J Pediatr Orthop. 1993. 13:672–675.

TOOLS

Similar articles