{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,3,10]],"date-time":"2026-03-10T01:44:09Z","timestamp":1773107049380,"version":"3.50.1"},"reference-count":18,"publisher":"Frontiers Media SA","license":[{"start":{"date-parts":[[2025,5,23]],"date-time":"2025-05-23T00:00:00Z","timestamp":1747958400000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":["frontiersin.org"],"crossmark-restriction":true},"short-container-title":["Front. Pediatr."],"abstract":"<jats:sec><jats:title>Introduction<\/jats:title><jats:p>Popliteal artery pseudoaneurysms are rare but potentially life-threatening complications following orthopedic procedures, particularly osteotomies. These pseudoaneurysms, characterized by a hematoma caused by disruption of the arterial wall and contained by surrounding tissues rather than all arterial layers, can cause severe ischemic damage if not promptly diagnosed and treated. Early detection and timely surgical intervention are critical to prevent catastrophic outcomes such as thrombosis, embolization, or limb loss. This case highlights the challenges in diagnosing and managing a delayed popliteal artery pseudoaneurysm caused by implant migration in a pediatric patient.<\/jats:p><\/jats:sec><jats:sec><jats:title>Case Presentation<\/jats:title><jats:p>A 15-year-old male patient with cerebral palsy presented with sudden, severe knee pain and localized swelling around the knee joint. These symptoms occurred two years after he underwent a distal femoral extension osteotomy with lateral plate fixation. Initial imaging studies were inconclusive, suggesting possibilities such as soft tissue sarcoma or hematoma. However, an incisional biopsy unexpectedly revealed a pseudoaneurysm cavity adjacent to the popliteal artery. Further imaging identified that the distal screws of the femoral plate had migrated posteriorly due to femoral deformity, causing direct irritation and injury to the artery.<\/jats:p><\/jats:sec><jats:sec><jats:title>Surgical Intervention<\/jats:title><jats:p>An urgent multidisciplinary surgical approach was implemented. The procedure began with femoral artery clamping to control bleeding, followed by excision of the pseudoaneurysm cavity. A saphenous vein graft was harvested and interposed to repair the damaged segment of the popliteal artery. To eliminate the source of irritation, the screws were removed. Postoperative ultrasonography confirmed successful arterial repair, with no signs of thrombosis or recurrence. The patient was mobilized early and discharged with an antiplatelet regimen, followed by regular clinical monitoring.<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusion<\/jats:title><jats:p>This case emphasizes the importance of routine follow-up in pediatric patients with orthopedic implants, as skeletal growth and deformity progression can lead to implant migration and serious vascular complications. The delayed diagnosis underscores the need for heightened clinical suspicion and comprehensive imaging in patients with unusual postoperative symptoms. Early recognition and timely multidisciplinary surgical intervention are crucial for preventing life-threatening vascular injuries. This case also highlights the necessity of individualized implant removal planning in growing patients to avoid similar complications.<\/jats:p><\/jats:sec>","DOI":"10.3389\/fped.2025.1560952","type":"journal-article","created":{"date-parts":[[2025,5,23]],"date-time":"2025-05-23T05:29:21Z","timestamp":1747978161000},"update-policy":"https:\/\/doi.org\/10.3389\/crossmark-policy","source":"Crossref","is-referenced-by-count":2,"title":["Late-onset popliteal artery pseudoaneurysm secondary to implant migration in a pediatric patient: a case report and surgical management"],"prefix":"10.3389","volume":"13","author":[{"given":"Senanur","family":"Duymaz","sequence":"first","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Burak","family":"Duymaz","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Onur","family":"Gursan","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"M. Can","family":"Kosay","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"1965","published-online":{"date-parts":[[2025,5,23]]},"reference":[{"key":"B1","doi-asserted-by":"publisher","first-page":"301","DOI":"10.1016\/S0883-5403(08)80087-3","article-title":"Popliteal aneurysm after total knee arthroplasty","volume":"5","author":"Hozack","year":"1990","journal-title":"J Arthroplasty"},{"key":"B2","doi-asserted-by":"publisher","first-page":"117","DOI":"10.5792\/ksrr.2014.26.2.117","article-title":"Popliteal artery pseudoaneurysm following primary total knee arthroplasty","volume":"26","author":"Shin","year":"2014","journal-title":"Knee Surg Relat Res"},{"key":"B3","doi-asserted-by":"publisher","first-page":"414","DOI":"10.1024\/0301-1526\/a000140","article-title":"Iatrogenic pseudoaneurysm of the popliteal artery following corrective tibial osteotomy","volume":"40","author":"Szyber","year":"2011","journal-title":"Vasa"},{"key":"B4","doi-asserted-by":"publisher","first-page":"519","DOI":"10.1016\/j.avsg.2007.01.009","article-title":"Late presentation of a mycotic popliteal artery pseudoaneurysm in the setting of a revised total knee arthroplasty complicated by both prior infection and periprosthetic fracture: a case report","volume":"21","author":"Behnke","year":"2007","journal-title":"Ann Vasc Surg"},{"key":"B5","doi-asserted-by":"publisher","first-page":"361","DOI":"10.1177\/153857440003400412","article-title":"Endovascular vein graft for the treatment of popliteal pseudoaneurysm","volume":"34","author":"Kwolek","year":"2000","journal-title":"Vasc Surg"},{"key":"B6","doi-asserted-by":"publisher","first-page":"306","DOI":"10.1007\/s00383-024-05887-7","article-title":"A decade of managing pediatric major traumatic vascular injuries: insights from a referral center","volume":"40","author":"Ab Rahman","year":"2024","journal-title":"Pediatr Surg Int"},{"key":"B7","doi-asserted-by":"publisher","first-page":"e22","DOI":"10.5435\/JAAOSGlobal-D-22-00050","article-title":"Indications for and risks associated with implant removal after pediatric trauma","volume":"6","author":"Montgomery","year":"2022","journal-title":"JAAOS: Glob Res Rev"},{"key":"B8","doi-asserted-by":"publisher","first-page":"448","DOI":"10.1055\/s-0042-1748799","article-title":"Challenges of skeletal reconstruction in growing children\u2014Hobson\u2019s choice","volume":"43","author":"Raja","year":"2022","journal-title":"Indian J Med Paediatr Oncol"},{"key":"B9","first-page":"144","article-title":"Removal of orthopedic implants in children: morbidity and postoperative radiologic changes","volume":"8","author":"Lovell","year":"1999","journal-title":"J Pediatr Orthop B"},{"key":"B10","doi-asserted-by":"publisher","first-page":"38","DOI":"10.13107\/jocr.2250-0685.1360","article-title":"Popliteal artery pseudoaneurysm after closing wedge high tibial osteotomy","volume":"9","author":"Santos-Pereira","year":"2019","journal-title":"J Orthop Case Rep"},{"key":"B11","doi-asserted-by":"publisher","first-page":"202","DOI":"10.1016\/j.rxeng.2024.07.002","article-title":"Imaging of pseudoaneurysms: key diagnostic findings, causes and complications","volume":"67","author":"Moreno Real","year":"2025","journal-title":"Radiolog\u00eda (English Edition)"},{"key":"B12","doi-asserted-by":"publisher","first-page":"1211","DOI":"10.7863\/jum.2006.25.9.1211","article-title":"Detection of a pseudoaneurysm in the knee joint with Doppler imaging after blunt trauma","volume":"25","author":"Karaosmanoglu","year":"2006","journal-title":"J Ultrasound Med"},{"key":"B13","doi-asserted-by":"publisher","first-page":"58","DOI":"10.1177\/1531003506298074","article-title":"Diagnosis and management of pseudoaneurysms","volume":"19","author":"Ashraf Mansour","year":"2007","journal-title":"Perspect Vasc Surg Endovasc Ther"},{"key":"B14","doi-asserted-by":"publisher","first-page":"95","DOI":"10.1097\/PAT.0000000000000050","article-title":"WHO classification of soft tissue tumours: an update based on the 2013 (4th) edition","volume":"46","author":"Jo","year":"2014","journal-title":"Pathology"},{"key":"B15","doi-asserted-by":"publisher","first-page":"615","DOI":"10.1016\/j.suc.2008.03.008","article-title":"Pediatric soft tissue sarcomas","volume":"88","author":"Loeb","year":"2008","journal-title":"Surg Clin North Am"},{"key":"B16","doi-asserted-by":"publisher","first-page":"499","DOI":"10.1177\/1538574406290037","article-title":"Traumatic pseudoaneurysm of the popliteal artery after blunt trauma: case report and a review of the literature","volume":"40","author":"Megalopoulos","year":"2007","journal-title":"Vasc Endovascular Surg"},{"key":"B17","doi-asserted-by":"publisher","first-page":"136","DOI":"10.1016\/j.ijsu.2015.04.056","article-title":"Management of traumatic popliteal vascular injuries in a level I trauma center: a 6-year experience","volume":"18","author":"Sciarretta","year":"2015","journal-title":"Int J Surg"},{"key":"B18","doi-asserted-by":"publisher","first-page":"133","DOI":"10.1016\/j.avsg.2023.12.067","article-title":"Autologous alternative vein grafts for infrainguinal bypass in the absence of single-segment great saphenous vein: a single-center study","volume":"103","author":"Biro\u0161","year":"2024","journal-title":"Ann Vasc Surg"}],"container-title":["Frontiers in Pediatrics"],"original-title":[],"link":[{"URL":"https:\/\/www.frontiersin.org\/articles\/10.3389\/fped.2025.1560952\/full","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2025,5,23]],"date-time":"2025-05-23T05:29:23Z","timestamp":1747978163000},"score":1,"resource":{"primary":{"URL":"https:\/\/www.frontiersin.org\/articles\/10.3389\/fped.2025.1560952\/full"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2025,5,23]]},"references-count":18,"alternative-id":["10.3389\/fped.2025.1560952"],"URL":"https:\/\/doi.org\/10.3389\/fped.2025.1560952","relation":{},"ISSN":["2296-2360"],"issn-type":[{"value":"2296-2360","type":"electronic"}],"subject":[],"published":{"date-parts":[[2025,5,23]]},"article-number":"1560952"}}