Pseudoaneurysm or false aneurysm can occur after either open or closed injury to the arterial wall. Haemorrhage becomes confined within fascial compartments resulting in a haematoma.The pathogenesis of the false aneurysm is characterised by a disruption of arterial continuity with extravasation of blood into surrounding tissues. Pseudoaneurysm of the lower extremity arteries occurs as a results of trauma or iatrogenic injury of the arterial wall. Although the majority of these complicate bone and soft tissue injury, iatrogenic injury during orthopaedic procedures is well documented. Pseudoaneurysm may cause complications including pain, rupture, bleeding, infection, peripheral embolisation, or deep venous thrombosis due to the venous compression.
False aneurysm formation involving the crural vessels is rare and these represent only 3–7% of all false aneurysms in total. A review of the literature revealed four previously documented cases involving either the peroneal artery or its perforating branch. Due to the relative rarity of infra-popliteal false aneurysm no standard treatment plan has been defined. In recent years authors have advocated both expectant treatment and intervention in the form of ligation, aneurysmotomy, or distal re-vascularisation. More recently coil embolisation has been successfully employed.