The authors describe a rare case of acute peripheral ischemia in a young patient, following a lower limb orthopaedic surgery. The clinical presentation and diagnosis tests suggested a Horton arteritis with peripheral symptoms, although the temporal artery biopsy was negative. Since the etiology was unclear, the authors considered the influence of local trauma (initial and surgical), of Ergot derivatives and antibiotic treatment, but the clinical outcome after corticotherapy strongly indicated a temporal arteritis.