Acute deep venous thrombosis and late onset axillary artery injury after a displaced, proximal humerus fracture-dislocation in an octogenarian patient

Abstract Background Axillary artery injury secondary to proximal humerus fracture is a rare but serious complication. The management of this injury has traditionally involved surgical treatment. Case summary A 66-year-old female with gait disturbance slipped and fell off her wheelchair at home. She presented to a local hospital with right shoulder pain and was subsequently urgently transferred to our hospital by helicopter because of suspicion of axillary artery injury. Computed tomography angiography revealed disruption of the right axillary artery. We decided to perform endovascular treatment instead of surgical treatment for axillary artery injury. However, since endovascular treatment via the right femoral artery was impossible, we performed bidirectional (right femoral and right brachial artery approaches) endovascular treatment. We expanded the occluded lesion using a 3.5 mm × 40 mm sized balloon and placed a 5.0 mm × 50 mm stent graft (Gore® Viabahn®) across the lesion. The final subclavian injection confirmed that distal flow to the brachial artery was preserved and that there was no leakage of contrast medium from the axillary artery. Discussion We performed endovascular treatment for axillary artery injury secondary to proximal humerus fracture. Although surgical repair is typically performed for this kind of injury, our experience suggests that endovascular treatment might be an option in patients with axillary artery injury.

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SEVER INFERIOR HUMERAL HEAD SUBLUXATION FOR 3 MONTHS IN PROXIMAL HUMERUS FRACTURE DISLOCATION

International Journal of Advanced Research ◽

10.21474/ijar01/13339 ◽

2021 ◽

Vol 9 (08) ◽

pp. 870-873

Author(s):

Emad M. Allehyani ◽

Ahmed K. Alsarhani ◽

Ahmed Alsyed

Keyword(s):

Humeral Head ◽

Proximal Humerus Fracture ◽

Proximal Humerus ◽

Axillary Nerve ◽

Fracture Pattern ◽

Humerus Fracture ◽

Fracture Dislocation ◽

Medical Illness ◽

Patient Factors

Proximal humerus fracture is common fracture 4-6% of all fractures (1), third most common non vertebral fracture in elderly >65 years (2), affecting female more than males in ratios of 2:1.Approximately half (51%) of these fractures are displaced, the majority of which involve the surgical neck (77%). (3) Surgical treatment (mainly internal fixation or humeral head replacement) is being increasingly used (4).Management of each fracture is dependent of patient factors, fracture pattern, and complexity.Case scenario:33 years old female not known to has any medical illness, presented to the emergency department with right shoulder pain and inability to move it after motor cycle accident. X-rayshowed proximal humerusfracture dislocation Upon Post-operative follow up patient developed sever inferior humeral head subluxation, With intact axillary nerve sensation and motor exam.Discussion:proximal humerus fracture is common, fracture pattern and type, with patient factors will guide your management.proximal humerus fracture dislocation is more difficult and challenging to surgeon in managing such fracture, with inferior hemeral head subluxation is common can reach to 42% in the radiographic incidence among proximal humerus fracture.

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Anterior proximal humerus fracture dislocation with concomitant glenoid fracture: An operative challenge! A case report

Trauma ◽

10.1177/14604086211019528 ◽

2021 ◽

pp. 146040862110195

Author(s):

Dheeraj Attarde ◽

Atul Patil ◽

Nilesh Kamat ◽

Parag Sancheti ◽

Ashok Shyam

Keyword(s):

Case Report ◽

Proximal Humerus Fracture ◽

Proximal Humerus ◽

Alternative Pathway ◽

Humerus Fracture ◽

Fracture Dislocation ◽

Anterior Dislocation ◽

Bony Union ◽

Glenoid Fracture ◽

Deltopectoral Approach

Introduction Combined proximal humerus fracture dislocation and glenoid fracture is a rare combination of injuries which presents technical operative challenges. There is little evidence to guide surgical management. Case Report We report a case of a proximal humerus fracture with anterior dislocation and glenoid fracture treated in the same sitting with open reduction and internal fixation with angular stability locking plate and cannulated screw. The surgical technique involved standard deltopectoral approach with coracoid osteotomy. Conclusion By addressing both fractures operatively at the same time, we reported a satisfactory clinical and functional outcome with bony union of the fracture sites without instability at end of 1 year. Coracoid osteotomy may open an alternative pathway to treat complex proximal humerus injuries with ipsilateral glenoid fracture.

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axillary artery injury following a closed fracture of the proximal humerus

Journal of Diagnostic Radiography and Imaging ◽

10.1017/s1460472805000040 ◽

2005 ◽

Vol 5 (3-4) ◽

pp. 147-149 ◽

Cited By ~ 1

Author(s):

f. lam ◽

i. kurta ◽

s. hussain

Keyword(s):

Literature Review ◽

Rare Case ◽

Proximal Humerus ◽

Axillary Artery ◽

Diagnosis And Treatment ◽

Humerus Fracture ◽

Closed Fracture ◽

Artery Injury ◽

Prompt Diagnosis

a rare case of axillary artery injury following a displaced surgical neck of humerus fracture is presented. the epidemiology and pathoanatomy of the condition are described. a literature review is presented emphasising the need for prompt diagnosis and treatment.

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