Dr. Jim Dooner
Victoria, BC
An 87 year old female suffered an impacted fracture of the distal ulna. It was immobilized in a dorsal slab, however over the next three weeks progressive swelling was
noted. The swelling became pulsatile and suspicion of an aneurysm was raised. Due to the distal location and the frailty of the patient, a one step intervention was
planned. Under a regional anaesthetic, an angiogram was performed in the Operating Room. Digital fluoroscopy revealed that there was indeed a false aneurysm of the Ulnar
artery, that the Radial artery was patent and that the palmar arch filled completely from the Radial side. The distal Ulnar artery filled retrograde. Since the Ulnar
artery was not essential, simple ligation of the vessel was acceptable rather than a complex interposition graft. The procedure was well tolerated and the patient was
discharged the following morning with adequate perfusion and normal sensorimotor function.
The accompanying images represent the operative findings.
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Angiogram conducted intraoperatively showing intact Radial artery and retrograde
filling of distal ulnar artery.
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Marked swelling of the wrist from traumatic false aneurysm of Ulnar artery.
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Aneurysm cavity openned with proximal and distal control. No interposition graft was used due to the adequacy of perfusion from the radial artery
through the palmar arches.
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Additional view of exposed aneurysm.
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