sunder and pseudo aneurysm

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In 2016 august 15, Sunder a 28 years old man from faridabad a factory worker, met with a accident while coming from work.He was  taken to Safdarjung hospital a large government hospital situated in New Delhi where treatment is largely free. He was taken up for surgery and external fixator was applied for reasons best known to surgical team.he was to be taken up for definitive fixation later on , alas that movement never come in a  busy govt hospital.In march he was admitted again and external fixator was removed and was put on compulsory wait for definitive fixation. Alas that movement never come. He started searching options in private sector.
Royal hospital was situated in NIT area of Faridabad Haryana, it was run by two brothers Anuj and Sunil Dhingra both orthopedic surgeons. Sunder come to them in early summer 2017 with a request that his leg may be amputated . They both disagreed from him and his mother . They both urged him to go for surgery for fixation of fracture to which his mother agreed. He under went intramedullery nailing in august 2017 post op was uneventful. He had complaint of bleeding from one of the pins sites of external fixator after one month of surgery  , post operative during routine post op visit one of person doing dressing accidently poked artery foceps into it. Suddenly huge amount of blood gushed out. Thigh also got big swelling. It was decided to get CT Angiogram done to know the problem and source of bleding. It showed a large psuedoaneursym of profunda femoris artery. Decision was made regarding surgery.I got call from Anuj on November 23,2017.

On 26 November 2017 we operated the patient a Sunday morning . My anaesthesist Dr Ayush while alighting from car shot a question can we do this surgery safely here?. Royal was small 30 bedded hospital with no blood bank support.I chose not to reply it, slowly we started , took control of femoral artery. Gradually we approached pseudo aneurysm  we drained the blood identified bleeding source and ligated it. It was from branch of vessel not main artery,Dr Sunil come to put screw to interlock nail . We closed the wound over drain.






















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