Delayed presentation of superficial femoral artery rupture: A case report

Femoral fractures with associated vascular injuries are uncommon but potentially life- or limb-threatening complications. This case report presents a 26-year-old male with an open distal femur fracture following a road traffic accident, managed initially with external fixation at a primary center. Upon referral 25 days later, during revision surgery, one external fixator pin was found to be piercing the superficial femoral artery, causing encasement with surrounding muscle. Emergency vascular intervention and end-to-end arterial anastomosis were performed successfully. The patient recovered without further complications, achieved bony union by six months, and was ambulatory by one year. This case highlights the risk of iatrogenic vascular injury, particularly with improper pin placement in the distal femur where vascular structures are anatomically vulnerable. Prevention through correct pin technique and early neurovascular monitoring is essential. Surgeons must be aware of anatomical landmarks and ensure careful planning to avoid such catastrophic complications.