Arteriovenous fistula of the deep femoral artery induced during PFNA fixation for intertrochanteric femoral fracture: a case report

We report the case of an 80-year-old woman who developed an arteriovenous fistula of the deep femoral arteries during proximal femoral nail antirotation (PFNA) fixation for an intertrochanteric femoral fracture. Six days after PFNA fixation, color Doppler ultrasonography and digital subtraction angiography revealed an arteriovenous fistula. The cause of vascular injury was believed to be misalignment of the guide pin. Embolization was successful. Five days later, the patient was discharged without complication. At the six-month follow-up, the wound and fracture had healed, and the patient was able to bear her full weight and had normal gait. Radiological imaging and a high index of clinical suspicion are necessary for diagnosing arteriovenous fistula associated with PFNA fixation, for which intervention is one of several treatment options.