Thrombosis of the Brachial Artery After Closed Elbow Dislocation

Abstract

Posterior dislocation of the elbow joint is the second commonest large joint dislocation that can be experienced due to various traumatic incidents. Although it may be associated with fractures and vascular lesions, in this case report, we describe a patient who encountered a posterolateral elbow dislocation following a fall on their arm with an extended elbow. This dislocation was followed by delayed thrombosis of the brachial artery, necessitating a revascularization surgery. For optimal patient care, physicians should remain vigilant, being cautious about potential vascular injuries both before and after performing a closed reduction of the elbow joint. The suspicion of vascular injury should be even more pronounced when bony lesions or open injuries are present. Effective management of such cases requires a collaborative effort between orthopedic and vascular surgeons. The preferred surgical approach involves the utilization of a saphenous graft, with the essential prerequisite of achieving a stable elbow joint before proceeding with revascularization.

Keywords: brachial artery thrombosis; complications of elbow dislocation; elbow dislocation; elbow injury; vascular graft.

Figure 1. Elbow radiographs demonstrate posterior elbow dislocation before reduction, with no signs of bone lesions.

(A) Anteroposterior (AP) view of elbow X-ray. (B) Lateral view of elbow X-ray

Figure 2. Radiographic view after closed reduction, where joint congruence is restored.

(A) Anteroposterior (AP) view of elbow X-ray. (B) Lateral view of elbow X-ray

Figure 3. Interposition of a saphenous vein graft for brachial artery repair.

(A)  Thrombosed brachial artery along a length of 4 centimeters. (B and C) The interposition graft utilized the distal portion of the ipsilateral saphenous vein.