Delayed presentation of Subclavian venous thrombosis following undisplaced clavicle fracture

Abstract

Medial clavicle fractures are uncommon, accounting for approximately 5 percent of all clavicle fractures. Vascular injuries are uncommon but are recognised as either an immediate complication due to transection of the vessel by the displaced fracture, or as a late complication, secondary to compression from abundant callus formation. We present an unusual case of positional venous insufficiency in the upper limb as an immediate complication of a closed, minimally displaced clavicle fracture, with secondary subclavian venous thrombosis formation eleven days following the injury.

Figure 1

AP X-Ray AP X-Ray showing an undisplaced fracture.

Figure 2

AP X-Ray showing an undisplaced fracture of the medial end of the clavicle.

Figure 3

Duplex scan – arm in flexion demonstrating vascular compromise.

Figure 4

Initial duplex scan – arm straight.

Figure 5

Venogram with arm flexed. This shows normal venous flow without occlusion.

Figure 6

Venogram image demonstrating poor axillary flow.