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Case Reports
. 2020 Dec 10:31:100378.
doi: 10.1016/j.tcr.2020.100378. eCollection 2021 Feb.

Penetrating angle grinder injury to the neck causing subclavian artery injury

Vincent Varley  1 , Matthew Claydon  1 , Jarryd Solomon  1 , Anastasia Dean  1 , Thomas Lovelock  1 , Mark C Fitzgerald  2
Affiliations
Case Reports

Penetrating angle grinder injury to the neck causing subclavian artery injury

Vincent Varley et al. Trauma Case Rep. .

Erratum in

Abstract

Penetrating injuries to the neck present a unique challenge due to the confined space of the thoracic outlet for haemorrhage control and repair. This results in high mortality rates when the major vascular structures of the neck are transected, as well as potential neurological compromise. We present the case of a penetrating injury to the proximal subclavian artery from a broken angle grinder disc which is a unique mechanism of injury that can have fatal consequences. The patient described in this case underwent an emergent median sternotomy for proximal control of the brachiocephalic trunk and ligation of the right vertebral artery to facilitate a primary repair of the injured vessel segment. Post operatively the patient made a complete recovery with no central or peripheral neurologic deficits and requiring no further interventions. The key points from this case are that angle grinders pose a significant injury burden and early specialised medical attention should be sought, rapid control of the proximal neck vessels can be obtained via a median sternotomy and that the vertebral artery can be ligated in an emergent situation without neurological consequence.

Keywords: Angle grinder; Penetrating; Penetrating neck; Subclavian; Thoracic outlet; Trauma.

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Conflict of interest statement

None.

Figures

Fig. 1
Fig. 1
Angle grinder with protective guard removed to fit a larger disc. https://www.worksafe.qld.gov.au/injury-prevention-safety/alerts/whsq/2017/guards-and-discs-on-angle-grinders.
Fig. 2
Fig. 2
Location of penetrating wound in Zone 1 of the neck.
Fig. 3
Fig. 3
A - Proximal subclavian artery with vessel loop B - Infraclavicular exposure for axillary artery control C - Common carotid artery with vessel loop D.- Phrenic nerve – looped for protection E – Aortic arch.
Fig. 4
Fig. 4
Injury and primary repair.
Fig. 5
Fig. 5
Management Algorithm for Subclavian and Axillary Artery Injuries. Western Trauma Association [6].
See this image and copyright information in PMC

References

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