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. 2015:8C:100-2.
doi: 10.1016/j.ijscr.2014.12.009. Epub 2014 Dec 12.

Brachial artery injury accompanying closed elbow dislocations

Patrick Harnarayan  1 , Shamir O Cawich  2 , Dave Harnanan  1 , Steve Budhooram  1
Affiliations

Brachial artery injury accompanying closed elbow dislocations

Patrick Harnarayan et al. Int J Surg Case Rep. 2015.

Abstract

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.

Keywords: Dislocation; Fracture; Trauma; Vascular.

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Figures

Fig. 1
Fig. 1
Open exploration of the injured elbow joint. Double yellow arrows demonstrate a segment of contused brachial artery. Single yellow arrows demonstrate the contused segment of the ulnar collateral artery; Blue arrows demonstrate the disrupted ends of the common flexor origin with markedly oedematous and contused remnant tissues.
Fig. 2
Fig. 2
Application of an external fixator to the reduced elbow joint.
Fig. 3
Fig. 3
Lateral and antero–posterior radiographs of the elbow joint post reduction and stabilization.
See this image and copyright information in PMC

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