Axillary artery lesions from humeral neck fracture: A study in relation to repair

Zhang,Quan; Wang,Shilong; Tang,Chaoliang; Chen,Wenjun; Zhang,Ye; Chen,Lin

doi:10.3892/etm.2012.775

January 2013 Volume 5 Issue 1

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January 2013 Volume 5 Issue 1

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Article

Axillary artery lesions from humeral neck fracture: A study in relation to repair

Authors:
- Quan Zhang
- Shilong Wang
- Chaoliang Tang
- Wenjun Chen
- Ye Zhang
- Lin Chen
View Affiliations / Copyright

Affiliations: Department of Orthopaedic Surgery, Huashan Hospital, Fudan University, Shanghai 200040, P.R. China, Department of Hand Surgery, Huashan Hospital, Fudan University, Shanghai 200040, P.R. China
Pages: 328-332
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Published online on: October 30, 2012

https://doi.org/10.3892/etm.2012.775
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Abstract

Whether axillary artery injuries associated with proximal humeral fractures must be repaired is uncertain. The present study reports three cases treated with various approaches. In case 1, the left humeral surgical neck was broken, the radial pulse disappeared and the arm temperature was significantly reduced. Computerized tomography angiography (CTA) revealed a 3-cm filling deficiency in the axillary artery. The injured artery was reconstructed with a segment of the greater saphenous vein after the fracture was reduced and fixed with a plate. In case 2, the axillary artery was compressed by the broken humeral segment, which caused the right hand to become cool. The fracture was fixed but the axillary artery embolism was not treated. In case 3, the humeral neck was broken with injury to the brachial plexus, although the patient's hand remained warm. Digital subtraction angiography (DSA) revealed that the axillary artery was injured badly but there was extensive collateral circulation. The proximal humeral fracture was reduced and fixed without artery reconstruction. The three cases all resulted in a good outcome with the bone healed and limb alive. No ischemic necrosis occurred. However, the neurapraxia did not dissappear completely. Axillary artery injury resulting from humeral neck fracture is a rare but disabling traumatic event. Early diagnosis based on signs of acute ischemia of the arm enables early treatment and a favourable outcome. An angiogram is the best way to diagnose the artery injury and evaluate the condition of the collateral circulation. The injured artery in a cold arm should be repaired, while in a warm arm reconstruction is unnecessary due to rich collateral circulation.

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Journals

International Journal of Molecular Medicine

International Journal of Oncology

Molecular Medicine Reports

Oncology Reports

Experimental and Therapeutic Medicine

Oncology Letters

Biomedical Reports

Molecular and Clinical Oncology

World Academy of Sciences Journal

International Journal of Functional Nutrition

International Journal of Epigenetics

Medicine International

Axillary artery lesions from humeral neck fracture: A study in relation to repair

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