Penetrating neck trauma and the aberrant subclavian artery

Brachial artery injury accompanying closed elbow dislocations

INTRODUCTION

Brachial artery injuries from elbow dislocations are uncommon, but they may lead to disastrous consequences if the diagnosis is delayed.

PRESENTATION OF CASE

We report a case of a patient who sustained a fall onto the elbow, with dislocation and brachial artery injury, despite an ipsilateral radial pulse being palpable.

DISCUSSION

Clinicians should maintain a high index of suspicion for brachial injury when patients present with a fall onto the elbow coupled with signs suggestive of fracture-dislocation, nerve injury and/or signs of limb ischemia. Frank ischamia, however, is uncommon as there is a rich collateral anastomosis in the upper limb.

CONCLUSION

A high index of suspicion should be maintained in order to make the diagnosis early. Exploration with excision of the injured segment and reverse vein interposition grafting is the treatment of choice in these cases.

Axillary Artery Injury Accompanying Humeral Neck Fracture

Injuries to the axillary artery from proximal humeral fractures are uncommon. There are only 66 such injuries reported across the world literature to date. We report an additional case of axillary artery injury. This case highlights the importance of maintaining a high index of suspicion to prevent diagnostic delay.