An 89 year old female patient had an osteoporotic right humeral shaft fracture that had never healed after placing an intramedullary nail and a distal locking screw seven years previously. She presented with a painful pulsatile mass on her right arm. The duplex scan (A) showed an osteosynthesis screw ($) protruding into a large pseudoaneurysm (#) from a defect in the displaced brachial artery (∗). The computed tomography angiogram performed for operative planning (B) confirmed these findings. The brachial artery defect was repaired with a saphenous vein interposition graft positioned away from the screw tip. The orthopaedic surgeon decided not to intervene.
