J Korean Fract Soc.  2012 Apr;25(2):146-149. 10.12671/jkfs.2012.25.2.146.

Delayed Brachial Artery Occlusion after Humeral Shaft Open Fracture: A Case Report

• Cho CH
• Bae KC
• Lee KJ
• Lee SW

• KMID: 2015459
• DOI: http://doi.org/10.12671/jkfs.2012.25.2.146

Abstract

Although vascular injury after humeral fracture is very rare, it is a complication that has serious sequelae. It has been associated with proximal humeral fracture or shoulder dislocation in adults and humeral supracondylar fracture in children. However, delayed brachial artery occlusion after humeral shaft fracture has never been reported worldwide. Nevertheless, delayed brachial artery occlusion after humerus shaft fracture has the potential to cause serious complications in the short term as well as long term; therefore, it is essential to provide accurate diagnosis and prompt treatment. We report a case of delayed brachial artery occlusion after humeral shaft open fracture that was successfully treated with early diagnosis as well as effective treatment.

Keyword

Humerus shaft fracture; Brachial artery; Occlusion; Delayed onset

MeSH Terms

Adult
Brachial Artery
Child
Early Diagnosis
Fractures, Open
Humans
Humeral Fractures
Humerus
Shoulder Dislocation
Shoulder Fractures
Vascular System Injuries

Figure

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  Fig. 1 Photograph shows 9 cm transverse open wound involving partial rupture of the muscles on the proximal 1/3 portion of the right arm.

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  Fig. 2 Initial anteroposterior (A) and lateral (B) plain radiographs show displaced transverse fracture of the humeral shaft.

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  Fig. 3 At 54 hours after injury, computed tomographic angiograph reveals occlusion of the right proximal brachial artery.

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  Fig. 4 Intraoperative angiogram after thrombectomy reveals revascularization of the radial artery, ulnar artery, and palmar arch arteries.

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  Fig. 5 (A) Closed reduction and intramedullary nailing was performed at 4 weeks after thrombectomy. (B, C) For nonunion of the fracture site, additional locking plate fixation with autogenous iliac bone graft was performed at 5 months postoperatively. (D) The fracture healed eventually without other complications.

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