title: Proximal humerus fractures with associated axillary artery injury.
abstract: Proximal humerus fractures have rarely been associated with injuries to the axillary artery. Most of the fractures described have been Neer 2-part surgical neck fractures with medialization of the shaft fragment and resultant laceration or thrombosis of the axillary artery. No intraoperative deaths have been reported. We present a series of 3 proximal humerus fractures, 2 of which are Neer 3- to 4-part anterior fracture dislocations, and associated axillary artery injury. There were 2 mortalities, 1 intraoperative. After a thorough review of the English literature, we identified an additional 11 cases of axillary artery injury associated with proximal humerus fracture. The purpose of this study was to heighten the clinical suspicion of this vascular injury in patients with proximal humerus fracture dislocations and surgical neck fractures with shaft medialization, as well as to review pathogenesis and guide management decisions.
authors.affiliation: Department of Orthopaedics and Rehabilitation, University of Rochester Medical Center, Rochester, NY.
authors.forename: Robert
authors.initials: R
authors.lastname: Thorsness
authors.forename: Christopher
authors.initials: C
authors.lastname: English
authors.forename: Jonathan
authors.initials: J
authors.lastname: Gross
authors.forename: Wakenda
authors.initials: W
authors.lastname: Tyler
authors.forename: Ilya
authors.initials: I
authors.lastname: Voloshin
authors.forename: John
authors.initials: J
authors.lastname: Gorczyca
mesh_terms: D000369:Aged, 80 and over; D001366:Axillary Artery / Q000293:injuries*; D017809:Fatal Outcome; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D009104:Multiple Trauma / Q000000981:diagnostic imaging / Q000601:surgery*; D011859:Radiography; D012784:Shoulder Fractures / Q000150:complications* / Q000000981:diagnostic imaging / Q000601:surgery*; D016896:Treatment Outcome; D057772:Vascular System Injuries / Q000000981:diagnostic imaging / Q000209:etiology* / Q000601:surgery*