Large pseudoaneurysm arising from the deep femoral artery after hip fracture fixation

Hip fracture is a common condition of increasing global concern. Vascular injury as a complication after hip fracture repair is rare. A 90-year-old woman developed swelling and pain to her proximal thigh 1 month after uneventful hip fracture fixation. Ultrasound revealed a large pseudoaneurysm of the deep femoral artery, which was successfully treated with transcatheter embolization. Pseudoaneurysms have numerous etiologies. In this case, vascular injury is suspected to be a consequence of proximal migration of the lesser trochanteric fragment. Unfortunately, pseudoaneurysms are often not appreciated due to the nonspecific nature of the presenting symptoms. Diagnosis should be confirmed radiologically and management depends on the location and size of the pseudoaneurysm, as well as patient comorbidities. Pseudoaneurysm after hip fracture fixation is a rare but serious complication. Diagnosis is challenging due to nonspecific symptoms. A high index of suspicion is imperative to prevent life-threatening rupture.