Open Access, Peer-reviewed
pISSN 1226-2102
eISSN 2005-8918
    J Korean Orthop Assoc. 2011 Aug;46(4):345-349. Korean.
    Published online Aug 31, 2011.
    https://doi.org/10.4055/jkoa.2011.46.4.345
    Copyright © 2011 by The Korean Orthopaedic Association
    Case Report

    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. and 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, Email: hykim@eulji.ac.kr
    Received March 21, 2011; Accepted May 19, 2011.

    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

    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.
      1. 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.
      1. National Institute of Child Health and Development (NICHD). Follow-up care of high-risk infants. Pediatrics 2004;114:1377–1397.
      1. Mactier H, Alroomi LG, Young DG, Raine PA. Central venous catheterisation in very low birthweight infants. Arch Dis Child 1986;61:449–453.
      1. 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.
      1. 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.
      1. 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.
      1. 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.
      1. 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.
      1. Peterson HA. Premature physeal arrest of the distal tibia associated with temporary arterial insufficiency. J Pediatr Orthop 1993;13:672–675.
    MeSH Terms
    Anti-Bacterial Agents
    Extremities
    Femoral Artery
    Humans
    Infant
    Infant, Newborn
    Infant, Premature
    Ischemia
    Lower Extremity
    Thromboembolism
    Tibia
    Metrics
    Share
    Figures
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