Axillary Artery Injury Accompanying Humeral Neck Fracture

Shamir O. Cawich; Patrick Harnarayan; Steve Budhooram; Vijay Naraynsingh

doi:10.1055/s-0034-1372246

International Journal of Angiology, Table of Contents

Int J Angiol 2015; 24(04): 296-299
DOI: 10.1055/s-0034-1372246

Case Report

Thieme Medical Publishers 333 Seventh Avenue, New York, NY 10001, USA.

Axillary Artery Injury Accompanying Humeral Neck Fracture

Shamir O. Cawich

¹Department of Clinical Surgical Sciences, University of the West Indies, St. Augustine, Trinidad and Tobago

,

Patrick Harnarayan

¹Department of Clinical Surgical Sciences, University of the West Indies, St. Augustine, Trinidad and Tobago

,

Steve Budhooram

¹Department of Clinical Surgical Sciences, University of the West Indies, St. Augustine, Trinidad and Tobago

,

Vijay Naraynsingh

¹Department of Clinical Surgical Sciences, University of the West Indies, St. Augustine, Trinidad and Tobago

› Author Affiliations

Abstract

Injuries to the axillary artery from proximal humeral fractures are uncommon. There are only 66 such injuries reported across the world literature to date. We report an additional case of axillary artery injury. This case highlights the importance of maintaining a high index of suspicion to prevent diagnostic delay.

Keywords

vascular - trauma - fracture - dislocation

Full Text

References

References
1 Gorthi V, Moon YL, Jo SH, Sohn HM, Ha SH. Life-threatening posterior circumflex humeral artery injury secondary to fracture-dislocation of the proximal humerus. Orthopedics 2010; 33 (3) . doi: 10.3928/01477447-20100129-29
2 Brahmamdam P, Plummer M, Modrall JG, Megison SM, Clagett GP, Valentine RJ. Hand ischemia associated with elbow trauma in children. J Vasc Surg 2011; 54 (3) 773-778
3 Matheï J, Depuydt P, Parmentier L, Olivie F, Harake R, Janssen A. Injury of the axillary artery after a proximal humeral fracture: a case report and overview of the literature. Acta Chir Belg 2008; 108 (5) 625-627
4 Soh RC, Tawng DK, Mahadev A. Pulse oximetry for the diagnosis and prediction for surgical exploration in the pulseless perfused hand as a result of supracondylar fractures of the distal humerus. Clin Orthop Surg 2013; 5 (1) 74-81
5 Yagubyan M, Panneton JM. Axillary artery injury from humeral neck fracture: a rare but disabling traumatic event. Vasc Endovascular Surg 2004; 38 (2) 175-184
6 Adovasio R, Visintin E, Sgarbi G. Arterial injury of the axilla: an unusual case after blunt trauma of the shoulder. J Trauma 1996; 41 (4) 754-756
7 Sukeik M, Vashista G, Shaath N. Axillary artery compromise in a minimally displaced proximal humerus fracture: a case report. Cases J 2009; 2: 9308
8 Kumar RM, Reddy SS, Sharma R, Mahajan R, Talwar KK. Endovascular repair of a traumatic axillary artery pseudoaneurysm. Cardiovasc Intervent Radiol 2009; 32 (3) 598-600
9 Manák P, Klein J. Axillary artery injury in closed fracture of the humeral neck. Acta Univ Palacki Olomuc Fac Med 1996; 140: 87-88
10 Steinberg I, Maitem AN. False aneurysm following fracture of limb. Angiographic study. N Y State J Med 1974; 74 (11) 2024-2026
11 Benedetti Valentini M, Farsetti P, Martinelli O, Laurito A, Ippolito E. The value of ultrasonic diagnosis in the management of vascular complications of supracondylar fractures of the humerus in children. Bone Joint J 2013; 95-B (5) 694-698
12 Calder FR, Gwyther SJ, Loosemore TM. Digital gangrene: an unusual late complication of non-union of a proximal humeral fracture. Injury 1997; 28 (9-10) 695-696
13 Jensen BV, Jacobsen J, Andreasen H. Late appearance of arterial injury caused by fracture of the neck of the humerus. J Trauma 1987; 27 (12) 1368-1369
14 Puri R, Clark J, Corkery PH. Axillary artery damage following a closed fracture of the neck of the humerus—a case report. Injury 1985; 16 (6) 426-427
15 van Embden D, Rhemrev SJ. A woman with a painful shoulder and cold hand [in Dutch]. Ned Tijdschr Geneeskd 2010; 154: A791
16 Shuck JM, Omer Jr GE, Lewis Jr CE. Arterial obstruction due to intimal disruption in extremity fractures. J Trauma 1972; 12 (6) 481-489
17 Adovasio R, Visintin E, Sgarbi G. Arterial injury of the axilla: an unusual case after blunt trauma of the shoulder. J Trauma 1996; 41 (4) 754-756
18 van Arkel ER, Tordoir JH, Arens HJ. A proximal humeral fracture, complicated by a pseudoaneurysm—a case report. Acta Orthop Scand 1998; 69 (2) 194-195
19 Edelmann K, Dvorák J, Kopp L, Obruba P. Proximal humeral fracture complicated by axillary artery lesion—a case review [in Czech]. Rozhl Chir 2010; 89 (9) 473-476
20 Carter SJ, Germann CA, Dacus AA, Sweeney TW, Perron AD. Orthopedic pitfalls in the ED: neurovascular injury associated with posterior elbow dislocations. Am J Emerg Med 2010; 28 (8) 960-965
21 Wenger JD, Olsson CJ. Acute limb ischemia after a proximal humeral epiphyseal fracture: intraoperative findings of an illustrative vascular lesion. J Shoulder Elbow Surg 2011; 20 (3) e1-e3
22 Jalili A, Mazhar FN, Ghahramani MH, Bahrabad M. Axillary artery injury with proximal humerus epiphyseal separation: a rare case report. Med J Islam Repub Iran 2012; 26 (4) 189-191
23 Seagger RM, Kitson J. A rare combination of an axillary artery and brachial plexus injury due to a proximal humeral fracture. Int J Shoulder Surg 2009; 3 (3) 71-73
24 Mouzopoulos G, Lassanianos N, Mouzopoulos D, Tzurbakis M, Georgilas I. Axillary artery injury associated with proximal humerus fractures. Vasa 2008; 37 (3) 274-277
25 Gallucci G, Ranalletta M, Gallucci J, De Carli P, Maignon G. Late onset of axillary artery thrombosis after a nondisplaced humeral neck fracture: a case report. J Shoulder Elbow Surg 2007; 16 (2) e7-e8
26 McLaughlin JA, Light R, Lustrin I. Axillary artery injury as a complication of proximal humerus fractures. J Shoulder Elbow Surg 1998; 7 (3) 292-294
27 Smyth EH. Major arterial injury in closed fracture of the neck of the humerus. Report of a case. J Bone Joint Surg Br 1969; 51 (3) 508-510
28 Laverick MD, D'Sa AA, Kirk SJ, Mollan RA. Management of blunt injuries of the axillary artery and the neck of the humerus: case report. J Trauma 1990; 30 (3) 360-361
29 Hoffheinz HJ. Injuries of axillary artery in fractures and dislocations in shoulder area [in German]. Monatsschr Unfallheilkd 1975; 78 (3) 129-133
30 Marty B, Simmen HP, Neff U, Habegger R. Subcapital humerus fracture with lesion of the axillary artery. 2 case reports and review of the literature [in German]. Unfallchirurg 1996; 99 (2) 154-157
31 Berga C, Prat S, Ninot S, Sanjuán MA, Mulet J. The arterial complications of closed injuries to the shoulder girdle [in Spanish]. Angiologia 1992; 44 (4) 139-143
32 Seitz J, Valdés F, Kramer A. Acute ischemia of the upper extremity caused by axillary contused trauma. Report of 3 cases [in Spanish]. Rev Med Chil 1991; 119 (5) 567-571
33 Lim EV, Day LJ. Thrombosis of the axillary artery complicating proximal humeral fractures. A report of three cases. J Bone Joint Surg Am 1987; 69 (5) 778-780
34 Barra JA, Le Saout J, Gaultier Y. Late signs of vascular complications of closed trauma of the shoulder (author's transl) [in French]. J Chir (Paris) 1978; 115 (3) 151-157
35 Theodorides T, de Keizer C. Injuries of the axillary artery caused by fractures of the neck of the humerus. Injury 1976; 8 (2) 120-123
36 Zhang Q, Wang S, Tang C, Chen W, Zhang Y, Chen L. Axillary artery lesions from humeral neck fracture: A study in relation to repair. Exp Ther Med 2013; 5 (1) 328-332
37 Modi CS, Nnene CO, Godsiff SP, Esler CN. Axillary artery injury secondary to displaced proximal humeral fractures: a report of two cases. J Orthop Surg (Hong Kong) 2008; 16 (2) 243-246
38 Maweja S, Sakalihasan N, Van Damme H, Limet R. Axillary artery injury secondary to anterior shoulder dislocation: report of two cases. Acta Chir Belg 2002; 102 (3) 187-191
39 Williams EW, Cawich SO, James M , et al. Penetrating neck trauma and the aberrant subclavian artery. West Indian Med J 2007; 56 (3) 288-293