J Korean Orthop Assoc.  1968 Feb;3(1):7-10. 10.4055/jkoa.1968.3.1.7.

Salvage of the Arm with Open Humeral Shaft Fracture with Major Vascular Injuries (a case report)

• Choi WS

• KMID: 2464771
• DOI: http://doi.org/10.4055/jkoa.1968.3.1.7

Abstract

Twenty-three years old male who sustained accidental machine injury to his right upper extremity. resulting in practically complete discontinuity, visited Chonnam University Hospital on september 30th 1964. Physical examination revealed fracture of left humerus. injury of brachial artery to venous channels, and almost complete laceration of all adjacent soft tissues, including muscles and skin. Three main nerves, radial, ulnar and median nerves, however, were found intact. The repair and reconstruction in the following order; fixation of the fracture, end-to-end anastomosis of the brachial artery, debridement and realignment of the muscles and skin sutures. These surgical procedures were completed within 6 hours from the time of accident. The arm was immobilized with shoulder spica cast for three months. The local circulation was recovered and the fracture healed completely, with restoration of the forearm and hand function but with sacrifice of the elbow and upper arm. This report presents detailed chnical descriptions on a particular case of open humeral shaft fracture with major vascular injuries and general discussions on the methods of arterial anastomosis in the extremities.

MeSH Terms

Arm*
Brachial Artery
Debridement
Elbow
Extremities
Forearm
Hand
Humans
Humerus
Jeollanam-do
Lacerations
Male
Median Nerve
Muscles
Physical Examination
Radial Nerve
Shoulder
Skin
Sutures
Upper Extremity
Vascular System Injuries*

Figure

• 

  Fig. 1. Schematic figure of the transverse division of the brachial artery, cephalic vein and basilic vein.

• 

  Humeral shaft fracture: There is complete irregular transverse fracture line of the mid-shaft of the humerus with medial displacement of the proximal portion

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  Fig. 2. Schematic figure of the end to end anastomosis

Reference

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