Vascular complications of tibial exostosis: A case of popliteal vein thrombosis.

Tibial exostosis, also known as osteochondroma, is a common benign bone tumor found predominantly in adolescents and young adults. Vascular complications associated with this tumor, such as arterial occlusion and pseudoaneurysm formation, are rare but can lead to significant morbidity if not promptly diagnosed and managed. We present a case of a 25-year-old patient who presented with thrombosis of the left popliteal vein and a painless swelling in the popliteal fossa. Radiographic and CT angiography revealed an exostosis on the proximal tibia causing arterial occlusion and venous compression. Surgical resection of the exostosis via a posterior knee approach resulted in successful resolution of symptoms and a favorable outcome at a 12-month follow-up. Histopathological examination confirmed the benign nature of the tumor with no evidence of malignant transformation. This case highlights the importance of prompt recognition and surgical intervention in managing vascular complications associated with tibial exostosis. A multidisciplinary approach involving orthopedic and vascular specialists is crucial for achieving optimal outcomes in such cases.

Early Supera stent fracture in the femoropopliteal artery.

The Supera peripheral stent has been designed to resist stent fracture, which can develop from the torsion and compressive forces in the femoropopliteal artery. We report on a case of Supera peripheral stent fracture in the early period after the index procedure in a patient with femoropopliteal artery disease. An individualised approach, considering the lesion location, patient's age and exercise capacity is important for the treatment of femoropopliteal artery disease.

Popliteal artery occlusion concomitant with a tibial plateau fracture and posterior cruciate ligament avulsion fracture.

In acute trauma, posterior cruciate ligament (PCL) injury may occur concomitantly with a bony fracture and be easily overlooked. A popliteal artery injury associated with a tibial plateau fracture and PCL avulsion fracture is rare. Missed or delayed diagnosis of this condition leads to a high amputation rate. Therefore, close attention is required with this type of injury. The limb can be saved though early detection and immediate reconstruction of the injured artery, followed by fasciotomy. We report here a rare case of popliteal artery occlusion proximal to the surgical zone, which was diagnosed after fixation of a medial tibial plateau fracture and posterior cruciate avulsion injury. In dashboard injuries without knee dislocation, the arterial intima may be injured and become vulnerable, even with an initial ankle brachial index greater than 0.9. This can cause concomitant occlusion of the popliteal artery due to iatrogenic retraction during surgery. Therefore, a neurovascular examination should be repeated to prevent delayed-onset thrombosis. To the best of our knowledge, this is the first case of popliteal artery injury concomitant with a tibial plateau fracture and PCL avulsion owing to initial dashboard injury-related arterial intima injury, which can present with a normal ankle brachial index.