Combined injury of femoral artery and femoral nerve after blunt trauma to the proximal femur: A case report

INTRODUCTION: Combined femoral arterial and nerve injury does not often occur in cases of proximal femur fracture (hip fracture) and is often overlooked in the emergency medical setting. Physicians should be aware of this rare but possible combination of injuries, which can lead to devastating and disabling patient outcomes. PRESENTATION OF CASE: A 42-year-old Ethiopian male was struck by a steel pipe, rushed to the emergency room, and diagnosed with a left subtrochanteric fracture of the femur. Although promptly taken to surgery for fixation and exploration of the femoral artery, it became necessary to amputate his leg 1 week later. DISCUSSION: Blunt injuries to the femoral nerve and femoral arterial tree are associated with high morbidity and mortality rates. These injuries should not be overlooked when diagnosing patients with blunt trauma to the femur. CONCLUSION: When treating patients presenting with blunt trauma to the femur, several factors may obfuscate the clinician’s need to perform a thorough examination of the femoral artery and femoral nerves. Among other things, the patient may not immediately present with signs of hemodynamic instability, similar to our reported case. The clinician may also be invested in treating the patient according to the Advanced Trauma Life Support protocol. When treating blunt hip trauma patients, clinicians should recognize that even blunt trauma to the femur may critically damage the femoral artery and nerve.