A Case of Humeral Head Fracture-dislocation with Vascular Injury: How We Managed it

Axillary artery injury is uncommon, although proximal humerus fractures are prevalent. The majority of axillary artery injuries in the literature have been attributed to anterior glenohumeral dislocation; a few have been linked to single proximal humerus fractures or fracture-dislocation. The axilla...

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Main Authors: K Meenakshisundaram, Nagesh C Sangolgi, Kandaswamy K G, Hari Sivanandan, Athipathi Sundararaj, Chiranjeevi K P
Format: Article
Language:English
Published: Jaypee Brothers Medical Publisher 2022-01-01
Series:Journal of Orthopedics and Joint Surgery
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Online Access:https://www.jojs.in/doi/JOJS/pdf/10.5005/jp-journals-10079-1100
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author K Meenakshisundaram
Nagesh C Sangolgi
Kandaswamy K G
Hari Sivanandan
Athipathi Sundararaj
Chiranjeevi K P
author_facet K Meenakshisundaram
Nagesh C Sangolgi
Kandaswamy K G
Hari Sivanandan
Athipathi Sundararaj
Chiranjeevi K P
author_sort K Meenakshisundaram
collection DOAJ
description Axillary artery injury is uncommon, although proximal humerus fractures are prevalent. The majority of axillary artery injuries in the literature have been attributed to anterior glenohumeral dislocation; a few have been linked to single proximal humerus fractures or fracture-dislocation. The axillary artery is vulnerable to injury because of a proximal humerus fracture due to its anatomical placement. Due to the quantity of collateral circulation in the upper limbs, vascular damage may occur even though the radial pulse is perceptible. The most common vascular injury produced by a proximal humerus fracture was an intimal rupture with subsequent thrombosis because there are no palpable peripheral pulses and no ischemia, axillary artery injury often goes undiagnosed at first, putting the hand at risk of necrosis and amputation if ischemia persists, and the forearm at risk of compartment syndrome after revascularization. A comprehensive physical examination, as well as a low threshold for Doppler tests or angiography, can diagnose axillary artery injury. Although the vascular insult resolves spontaneously, it is vital to recognize the link between such fractures and vascular injuries in order to diagnose them early and avoid major complications, such as amputation. We provide a case of axillary artery injury associated with proximal humerus fractures to show the risk of axillary artery injury in the setting of proximal humerus fractures.
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spelling doaj-art-406d8f135c9c489189ecdb02bac7486b2025-08-20T02:28:00ZengJaypee Brothers Medical PublisherJournal of Orthopedics and Joint Surgery2582-78632022-01-0142919310.5005/jp-journals-10079-110010A Case of Humeral Head Fracture-dislocation with Vascular Injury: How We Managed itK Meenakshisundaram0Nagesh C Sangolgi1Kandaswamy K G2Hari Sivanandan3Athipathi Sundararaj4Chiranjeevi K P5Department of Orthopedics, Vinayaka Missions Kirupananda Variyar Medical College & Hospital, Salem, Tamil Nadu, IndiaNagesh C Sangolgi, Department of Orthopedics, Vinayaka Missions Kirupananda Variyar Medical College & Hospital, Salem, Tamil Nadu, India, Phone: +91 8123451238Department of Orthopedics, Vinayaka Missions Kirupananda Variyar Medical College & Hospital, Salem, Tamil Nadu, IndiaDepartment of Orthopedics, Vinayaka Missions Kirupananda Variyar Medical College & Hospital, Salem, Tamil Nadu, IndiaDepartment of Orthopedics, Vinayaka Missions Kirupananda Variyar Medical College & Hospital, Salem, Tamil Nadu, IndiaDepartment of Orthopedics, Vinayaka Missions Kirupananda Variyar Medical College & Hospital, Salem, Tamil Nadu, IndiaAxillary artery injury is uncommon, although proximal humerus fractures are prevalent. The majority of axillary artery injuries in the literature have been attributed to anterior glenohumeral dislocation; a few have been linked to single proximal humerus fractures or fracture-dislocation. The axillary artery is vulnerable to injury because of a proximal humerus fracture due to its anatomical placement. Due to the quantity of collateral circulation in the upper limbs, vascular damage may occur even though the radial pulse is perceptible. The most common vascular injury produced by a proximal humerus fracture was an intimal rupture with subsequent thrombosis because there are no palpable peripheral pulses and no ischemia, axillary artery injury often goes undiagnosed at first, putting the hand at risk of necrosis and amputation if ischemia persists, and the forearm at risk of compartment syndrome after revascularization. A comprehensive physical examination, as well as a low threshold for Doppler tests or angiography, can diagnose axillary artery injury. Although the vascular insult resolves spontaneously, it is vital to recognize the link between such fractures and vascular injuries in order to diagnose them early and avoid major complications, such as amputation. We provide a case of axillary artery injury associated with proximal humerus fractures to show the risk of axillary artery injury in the setting of proximal humerus fractures.https://www.jojs.in/doi/JOJS/pdf/10.5005/jp-journals-10079-1100axillary artery injuryhumeral head fracture-dislocationproximal humerus fracture dislocationvascular injury
spellingShingle K Meenakshisundaram
Nagesh C Sangolgi
Kandaswamy K G
Hari Sivanandan
Athipathi Sundararaj
Chiranjeevi K P
A Case of Humeral Head Fracture-dislocation with Vascular Injury: How We Managed it
Journal of Orthopedics and Joint Surgery
axillary artery injury
humeral head fracture-dislocation
proximal humerus fracture dislocation
vascular injury
title A Case of Humeral Head Fracture-dislocation with Vascular Injury: How We Managed it
title_full A Case of Humeral Head Fracture-dislocation with Vascular Injury: How We Managed it
title_fullStr A Case of Humeral Head Fracture-dislocation with Vascular Injury: How We Managed it
title_full_unstemmed A Case of Humeral Head Fracture-dislocation with Vascular Injury: How We Managed it
title_short A Case of Humeral Head Fracture-dislocation with Vascular Injury: How We Managed it
title_sort case of humeral head fracture dislocation with vascular injury how we managed it
topic axillary artery injury
humeral head fracture-dislocation
proximal humerus fracture dislocation
vascular injury
url https://www.jojs.in/doi/JOJS/pdf/10.5005/jp-journals-10079-1100
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