Identifying Variants and Prevalence of the Superficial Brachial Artery – A Case Series

Objectives Two to 20% of pediatric supracondylar humerus fractures present with abnormal vascular examinations ranging from ischemic hands to perfused pulseless hands. Management of perfused pulseless hands with observation or surgical exploration remains debatable. We report management and outcomes of five cases at our institution. Methods Charts of patients <18 years old with supracondylar humerus fractures undergoing brachial artery exploration from 2009 to 2016 were reviewed. Results Five patients presented with supracondylar humerus fracture after falls. Closed reduction and percutaneous pinning resulted in five pink hands, one with a palpable pulse and one with return of radial Doppler signal. Two were admitted for observation and one underwent immediate brachial artery exploration. The four cases initially managed non-operatively underwent exploration. Intraoperative findings included three brachial artery entrapments, one arterial compression due to hematoma, and one complete arterial transection requiring thrombectomy and venous interposition graft. At follow-up, all patients had palpable radial pulses. Conclusions Perfused pulseless hands after supracondylar humerus fracture reduction require close monitoring. Cases without return of radial Doppler signals should undergo immediate brachial exploration. We recommend duplex ultrasound for the diagnosis of brachial artery injury as an early guide to surgical exploration to prevent treatment delay and arm or hand ischemia.

Download Full-text

Superficial brachial artery

VASA ◽

10.1024/0301-1526.34.3.195 ◽

2005 ◽

Vol 34 (3) ◽

pp. 195-197

Author(s):

Atahan ◽

Cetinus ◽

Yasim

Keyword(s):

Upper Extremity ◽

Female Patient ◽

Upper Limb ◽

Brachial Artery ◽

Health Professionals ◽

Invasive Procedures ◽

Arterial Variation ◽

Superficial Brachial Artery ◽

Therapeutic Procedures ◽

The Right

Anomalies of the ramification of arteries in the upper extremity are an important consideration due to the large number of invasive procedures, both diagnostic and therapeutic, performed particularly in the cubital region of the upper limb. It is important for health professionals to be aware of arterial variation to prevent complications during diagnostic and therapeutic procedures. Here, we describe a rare unilateral anomaly of the brachial artery which courses subcutaneously through the right arm to the cubital region in a 75 year-old female patient.

Download Full-text

Closed Humerus Shaft and Distal Humerus Fractures with associated Brachial Artery Thrombosis in Adult Patients and its Management – A Case Series

Journal of Orthopaedic Case Reports ◽

10.13107/jocr.2021.v11.i06.2282 ◽

2021 ◽

Vol 11 (6) ◽

Author(s):

Neetin P Mahajan ◽

Prasanna Kumar G S ◽

Vaibhav Sakhare

Keyword(s):

Brachial Artery ◽

Case Series ◽

Distal Humerus ◽

Shaft Fracture ◽

Vascular Surgeon ◽

Artery Thrombosis ◽

First Case ◽

Humerus Shaft Fracture ◽

Humerus Fractures ◽

Humerus Shaft

Introduction: The humerus fractures can present as isolated or associated with other injuries and these fractures can be associated with both primary and secondary iatrogenic or traumatic neurovascular injuries. The timely management of these injuries helps in preventing catastrophic consequences. Case Presentation: Two cases of humerus fractures were presented with brachial artery thrombosis. First case is 56-year-old female with distal humerus fracture and second is 32-year-old female with humerus shaft fracture. Both the patients had feeble pulse at the time of presentation. Urgent CT angiography of the upper limb was performed and vascular surgeon intervention was taken. First case showed complete non opacification of distal brachial artery due to thrombosis, which was managed with bicolumnar plating with embolectomy. The second case of humerus shaft fracture showed non contrast opacification at the fracture, which was managed with intramedullary nailing with removal of the bony fragment impinging on the artery and embolectomy. Postoperatively, both the patients are having good functional and radiological outcome without any complications. Conclusion: Proper early clinical evaluation for vascular deficits helps to prevent the delayed diagnosis and radiological investigations helps to identify the cause and location of the vascular insults. Early surgical intervention in association with vascular surgeons helps in getting better outcome and prevents complications related to vascular injuries. Keywords: Distal humeral fracture, brachial artery thrombosis, humerus shaft fracture, embolectomy.

Download Full-text