Objective:

To report a rare case of profunda femoris vein laceration caused by a displaced lesser trochanteric fragment during the management of an intertrochanteric fracture, highlighting the rarity of this complication.

Key Findings:

• A 3 mm laceration of the profunda femoris vein was discovered intraoperatively despite negative preoperative Doppler ultrasound.
• The displaced lesser trochanteric fragment was in direct contact with the profunda femoris vein, posing a significant risk of injury.
• Postoperatively, the patient developed deep vein thrombosis.

Interpretation:

This case underscores the potential for venous injury during hip fracture surgery, even when preoperative imaging does not indicate vascular compromise, emphasizing the need for careful surgical planning.

Limitations:

• This is a single case report and cannot establish definitive management protocols.
• The absence of preoperative vascular imaging techniques like CTA limits comprehensive risk assessment.
• Potential for bias in a single case report.

Conclusion:

The proximity of a displaced lesser trochanteric fragment to major vessels necessitates careful preoperative imaging review and consideration of intraoperative vascular exploration, highlighting the importance of assessing vascular risks.