title: Non-union of a clavicle fracture: lateral fragment excision for brachial artery embolism.
abstract: A 67-year-old motorcyslist was admitted to hospital following a high-speed road traffic collision and found to have a left midshaft clavicle fracture and multiple ipsilateral rib fractures. He was treated conservatively and went on to have non-union of the clavicle. The non-union was managed non-operatively. The patient then re-attended the hospital with an acute ischaemic left hand 3 years after the original injury date. An arterial duplex scan confirmed a embolus to the brachial artery. A brachial embolectomy was urgently performed. A computed tomography scan showed non-union of the clavicle fracture and an inflammatory mass compressing the left subclavian artery, which was the focus of the embolic event. The clavicle non-union was managed operatively with lateral half claviculectomy. Immediately after clavicle excision, the vascular team performed reconstruction of the brachial artery. At follow-up,there was normal shoulder and hand function at outpatient clinic. A duplex scan confirmed good triphasic waveforms throughout the arteries of the left upper limb.
authors: Department of Orthopaedic Surgery, Blackpool Victoria Hospital, Blackpool, Lancashire, UK.
authors: Syed
authors: S
authors: Hassan
authors: Department of Orthopaedic Surgery, Blackpool Victoria Hospital, Blackpool, Lancashire, UK.
authors: Elizabeth
authors: E
authors: Burgess
authors: Department of Orthopaedic Surgery, Blackpool Victoria Hospital, Blackpool, Lancashire, UK.
authors: Bheem
authors: B
authors: Sangars
authors: Department of Orthopaedic Surgery, Blackpool Victoria Hospital, Blackpool, Lancashire, UK.
authors: Vittorio
authors: V
authors: Perricone
authors: Department of Orthopaedic Surgery, Blackpool Victoria Hospital, Blackpool, Lancashire, UK.
authors: Charalambos P
authors: CP
authors: Charalambous
keywords: Clavicle non-union; arterial thoracic outlet syndrome; claviculectomy