Axillary artery injury secondary to displaced proximal humeral fractures: a report of two cases.
We report 2 cases of axillary artery injury secondary to low-energy proximal humeral fractures. In case 1, early diagnosis based on signs of acute ischaemia of the arm enabled early treatment and a favourable outcome. In case 2, there were no signs of ischaemia or neurological deficit, resulting in delayed diagnosis and increased severity of the injury. The patient developed a false aneurysm and sepsis and eventually died. A high index of suspicion is necessary for diagnosing an axillary artery injury. We recommend that all patients with proximal humeral fractures with severe medial displacement of the shaft and a bone spike should routinely undergo Doppler ultrasound scanning to rule out vascular injuries and the presence of a false aneurysm.
Modi
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CS
Warwick Orthopaedics, University Hospitals Coventry and Warwickshire NHS Trust, United Kingdom. chet_modi@hotmail.com
Nnene
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Godsiff
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Esler
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D000058:Accidental Falls; D000328:Adult; D000368:Aged; D001366:Axillary Artery / Q000293:injuries*; D005260:Female; D005593:Fracture Fixation, Internal / Q000379:methods; D006801:Humans; D006810:Humeral Fractures / Q000150:complications* / Q000000981:diagnostic imaging / Q000601:surgery; D014057:Tomography, X-Ray Computed