# Following Multiple Failed Reconstructions of a Distal Femur Fracture, Osseous Union Achieved After Superficial Femoral Artery Endarterectomy

## TL;DR

A man's broken femur failed to heal after multiple surgeries until a blocked artery was treated, restoring blood flow and allowing the bone to heal.

## Contribution

Demonstrates that resolving arterial occlusion can lead to successful bone healing in nonunion femur fractures.

## Key findings

- Multiple surgeries failed to heal the distal femur fracture due to nonunion.
- Endarterectomy of the superficial femoral artery improved blood flow and enabled osseous union.
- Arterial occlusion was identified as a contributing factor to the delayed healing.

## Abstract

Nonunion of a distal femur fracture is a serious complication in which bone healing ceases or fails to resolve, often necessitating further surgical intervention. Poor blood supply and unstable fixation have been identified as contributing factors to osseous nonunion. In this case, we highlight a challenging femur fracture that achieved osseous union only after resolution of a superficial femoral artery occlusion via endarterectomy that improved blood flow to the fracture site.

A 54-year-old male was involved in a high-speed motor vehicle accident that resulted in a left distal femur fracture. The patient underwent multiple reconstructive procedures that were complicated by hardware failure and recurrent nonunion. Prior to the sixth reconstruction, a superficial femoral artery occlusion was discovered and addressed with endarterectomy. The sixth and final procedure resulted in osseous union and stable fixation of the femur fracture.

A missed superficial femoral artery occlusion likely contributed to the delay in achieving osseous union of a traumatic comminuted distal femur fracture.