Axillary Artery Pseudoaneurysm following Severely Displaced Proximal Humerus Fracture: Delayed Presentation and Management

2010 ◽  
Vol 2 (2) ◽  
pp. 100-102
Author(s):  
Thomas Kurien ◽  
Amol Tambe ◽  
David I. Clark

Delayed presentation of axillary artery injuries after displaced proximal humeral fractures are rare. We present a report on an 88 year old female who developed a pseudoanersym of the axillary artery 3 weeks after a proximal humeral fracture and a novel approach to the management of this potentially limb and life threatening complication.

Author(s):  
Mohd Shaffid Md Shariff ◽  
Hanizah Ngadiron ◽  
Firdaus Hayati ◽  
Nornazirah Azizan ◽  
Affirul Chairil Ariffin

Fracture is common after trauma. Proximal humeral fracture can occur in the elderly after fall and in youngsters after motor vehicle accidents (MVA) and sport injuries. A 37-year-old man was admitted with a fracture of his left proximal humerus following an MVA. He sustained a 3-part fracture and treated surgically using a PHILOS plate. There are few options in managing proximal humerus fracture ranging from conservative to surgical intervention based on its severity. We reminiscent the usage of PHILOS plate as a mode of treatment of such fracture. 


2014 ◽  
Vol 17 (3) ◽  
pp. 120-126
Author(s):  
Chang Hyuk Choi ◽  
Jung Hyun Sim ◽  
Sang Hwa Lee ◽  
Joo Hwan Lee ◽  
Jun Ho Nam

BACKGROUND: To compare the treatment of the proximal humerus fracture using a Polarus nail or Philos plate, we aimed to analyze the functional recovery and the factors affecting the selection between the two types of surgery.METHODS: The study included 107 patients with proximal humerus fracture who underwent surgery at our institution. Of these patients, 67 underwent surgery with Polarus nails (G1) and 40 with Philos plates (G2). In G1, the cases of two- and three-part fractures were 60 and 7 cases, in G2, the cases of two-, three-, and four-part fractures were 28, 10, and 2 cases, respectively. The average age was 61 years old, and the average follow-up period was 32.5 months. We compared radiological results, the functional recovery retrospectively.RESULTS: The radiological union time was 6.8 weeks and 8.7 weeks on average in G1 and G2 (p < 0.05). At the one-year follow-up period, these were visual analogue scale (VAS) 1.355, forward flexion (FF) 130.968, external rotation (ER) 50.161, internal rotation (IR) L2 in G1, and VAS 0.781, FF 135.806 ER 51.25, IR L1 in G2, respectively, showing no significant differences between the two groups (p > 0.05). Similar observations were made at the final follow-up. In terms of functional recovery, no significant differences were seen at the one-year or at the final follow-up period (p > 0.05).CONCLUSIONS: For the surgical treatment of proximal humeral fracture, the selection of the type of surgery is affected by the fracture pattern. However, both methods give satisfactory outcomes and do not show significant differences in the functional outcome after the surgery.


2019 ◽  
Vol 158 (04) ◽  
pp. 406-413
Author(s):  
Sam Razaeian ◽  
Saad Rustum ◽  
Lena Sonnow ◽  
Rupert Meller ◽  
Christian Krettek ◽  
...  

Abstract Background Proximal humerus fractures account for 4 – 6% of all fractures and are a common result of low-energy trauma in the elderly. Concomitant neurovascular injury of the neighboring axillary artery and brachial plexus is a rarity, but has enormous impact on therapy, rehabilitation and prognosis. Diagnosis of axillary artery injury may be delayed due to its varied clinical presentation and lead to prolonged ischemia, distal necrosis and even loss of limb. Thorough clinical examination, high suspicion and identification of known predictors can be helpful in early diagnosis of this rare injury. Patients/Material and Methods We report a case of an intoxicated 76-year-old male who sustained a dislocated proximal humerus fracture, resulting in concomitant brachial plexopathy and axillary artery dissection with secondary thrombosis after a low-energy fall from standing height. Due to mistriage as a neurological emergency the somnolent patient presented under delayed circumstances at our traumatological emergency department, demonstrating pain, paleness, paralysis, paresthesia and non-palpable wrist pulses. Diagnosis was made through high suspicion after clinical examination with the aid of CT angiography. Emergent open reduction and anatomic shoulder hemiarthroplasty was performed followed by axillobrachial interposition grafting using a reversed saphenous vein graft and brachial plexus exploration. Results The surgical treatments were uncomplicated. The affected limb remains viable at 6-week follow-up; however, active shoulder function is limited due to residual brachial plexopathy. Conclusion Despite early diagnosis and management of this rare injury, the prognosis for functional recovery is guarded and largely dictated by the extent of neurological injury in the setting of concomitant brachial plexopathy. Brachial plexopathy is highly associated with axillary artery injury and its impact often underestimated in comparison due to its non-limb-threatening nature in the acute setting. Future studies should focus on the long-term prognosis for functional recovery in patients with this rare injury pattern.


2009 ◽  
Vol 20 (1) ◽  
pp. 51-54
Author(s):  
Masaki Katoh ◽  
Yuki Iijima ◽  
Yusuke Ueda ◽  
Motohiko Oyama ◽  
Kazuo Saita ◽  
...  

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