Amputation for upper extremity ischemia following shoulder dislocation: case report and a review of literature

Year 2015, Volume: 1 Issue: 2, 66 - 70, 04.07.2015

Murat Songur , Ercan Sahin , Mahmut Kalem , Sinan Zehir

https://doi.org/10.18621/eurj.2015.1.2.66

Cited By: 2

Abstract

Injury of the axillary artery following glenohumeral dislocation is a very rare situation. The mechanisms for arterial injuries are lacerations, rupture, avulsion of main branches or intimal tears and pseudo aneurysm formations. In this report we present an upper extremity ischemia following shoulder dislocation resulting with loss of extremity. Our aim was to highlight the importance of the third part of axillary artery and consequences of underestimation of vascular pathologies following shoulder injuries.

Keywords

Axillary, artery, shoulder, dislocation, amputation

References

• [1] Kelley SP, Hinsche AF, Hossain JFM. Axillary artery transection following antterior shoulder dislocation: clinical presentation and current concepts. Injury. 2004;35:1128-32.
• [2] Stayner LR, Cummings J, Andersen J, Jobe CM.Shoulder Dislocations in patients older than 40 years of age. Orthop Clin North Am. 2000;31(2):231-9.
• [3] Byrd RG, Ryland RP, Roy TM. Axillary artery injuries after proximal fracture of the humerus. Am J Emerg Med. 1998;16:154-6.
• [4] Nicholson DA. Arterial injury following shoulder trauma: a report of two cases. Br J Radiol. 1991;64(766):961-3.
• [5] McLaughlin JA, Light R, Lustrin I. Axillary artery injury as a complication of proximal humerus fractures. J Shoulder Elbow Surg. 1998;7(3):292-4.
• [6] Zuckerman JD, Flugstad DL, Teitz CC, et al: Axillary injury as a complication of proximal humeral fractures: Two case reports and a review of the literature. Clin Orthop. 1984;189:234-7.
• [7] Rockwood C, Matsen F. Glenohumeral instability. In Rockwood C, Matsen F (eds):The Shoulder, 2nd ed. Philadelphia, WB Saunders, 1998, pp 611-754.
• [8] Warwick R, Williams PL. Gray’s anatomy. 35th ed. Edinburgh: Longman,1973:647-9.
• [9] Gates JD, Knox JB. Axillary artery injuries secondary to anterior dislocation of the shoulder. J Trauma. 1995 Sep;39(3):581-3.
• [10] Nash E, Soudry M, Abrahamson J, Mendes D. Neuropraxis secondary to hemorrhage in a traumatic dislocation of the shoulder. J Orthop Trauma 1984;24(6):546-7.
• [11] Nichols JS, Lillehei KO. Nerve injury associated with acute vascular trauma. Surg Clin North Am. 1988 Aug;68(4):837-52.
• [12] Byström S, Vinnars B. Late posttraumatic compartment syndrome in the axillary neurovascular sheath--a case report. Acta Orthop Scand. 1999;70(5):519-22.
• [13] Helm AT, Watson JS. Compression of the brachial plexus in a patient with false aneurysm of the axillary as a result of anterior shoulder dislocation. J Shoulder Elbow Surg. 2002;11:278-9.
• [14] Fitzgerald JF, Keates J. False aneurysm as a late complication of anterior dislocation of the shoulder. Ann Surg. 1975;181:785-7.
• [15] Majeed L. Pulsatile haemarthrosis of the shoulder joint associated with false aneurysm of the axillary artery as a late complication of anterior dislocation of the shoulder. Injury. 1985;16:566-7.
• [16] Stenning M, Drew S, Birch R. Low-energy arterial injury at the shoulder with progressive or delayed nerve palsy. J Bone Joint Surg Br. 2004;87B:1102-6.
• [17] Tsutsumi K, Saito H, Ohkura M. Traumatic pseudoaneurysm of the subclavian artery following anterior dislocation of the shoulder; A report of a surgical case. Ann Thorac Cardiovasc Surg. 2006;12:74-6.
• [18] Eastcott HHG, BlaisdellFW, Silver D. Acute ischemia In: Eastcott HHG, ed. Arterial surgery. Third ed. Edinburgh: Churchill Livingstone,1992:31-54.
• [19] Stahnke M, Duddy MJ. Endovascular repair of a traumatic axillary pseudoaneurysm following anterior shoulder dislocation. Cardiovasc Intervent Radiol. 2006;29:298-301.
• [20] St John FB, Scudder J, Stevens DL. Spontaneous rupture of axillary artery. Ann Surg. 1945;121(6):882-90.
• [21] Lodding P, Angeras U. Fatal axillary artery injury following anterior dislocation of the shoulder. Ann Chir Gynaecol. 1988;77(3):125-7.
• [22] Cook LB, Varley S. Fatal tracheal compression after haemorrhage into the axilla. Br J Anaesth. 1992;69:322-4.
• [23] Modi CS, Nnene CO, Godsiff SP, Esler CNA. Axillary artery injury secondary to displaced proximal humeral fractures: a report of two cases. J Orthop Surg (Hong Kong). 2008;16(2):243-6.
• [24] Mouzopoulos G, Lasanianos N, Mouzopoulos D, Batanis G, Tzurbakis M, Georgilas I. Acute renal failure due to rhabdomyolysis after proximal humerus fracture associated with axillary artery rupture. Int Urol Nephrol. 2008;40:855-8.
• [25] McKenzie AD, Sinclair AM. Axillary artery occlusion complicating shoulder dislocation. A report of two cases. Ann Surg.1958;148(1):139-41.
• [26] Gibson JMC. Rupture of the axillary artery. J Bone Joint Surg Br.1962;44B(1):114-5.
• [27] McQuillan WM, Nolan B. Ischemia complicating injury. J Bone Joint Surg Br.1958;50B(3):482-92.
• [28] Smyth EHJ. Major arterial injury in closed fracture of the neck of the humerus. J Bone Joint Surg Br.1969;51B(3):508-10.
• [29] Sathyarup D, Huilgol AK, Iyer KM. Axillary artery thrombosis. Injury 1958;19(1):45-7.
• [30] Ng KC, Singh S, Low YP. Axillary artery damage from shoulder trauma- a report of two cases. Singapore Med J. 1990;31:592-5.
• [31] Syed AA, Williams HR. Shoulder disarticulation: a sequel of vascular injury secondary to a proximal humeral fracture. Injury. 2002;33:771-4.
• [32] Mathieu L1, Chetboun A, Nourissat G, Doursounian L. Rupture of axillary artery and brachial plexus paralysis as complications of recurrent anterior glenohumeral dislocation: a case report. Chir Main. 2009 Apr;28(2):103-6. doi: 10.1016/j.main.2009.01.002.
• [33] Nour M1, Zerhouni H, Bensaid B, Khaloufi S, Ouazzani L, Aqquaoui L, Elhami I, Oubejja H, Erraji M, Ettayebi F. Axillary artery pseudo-aneurysm secondary to shoulder dislocation in children. J Mal Vasc. 2013 Dec;38(6):377-80.
• [34] Ergünes K, Yazman S, Yetkin U, Cakir V, Gurbuz A. Axillary artery transection after shoulder dislocation. Ann Vasc Surg. 2013 Oct;27(7):974.e7-10.
• [35] Rangdal SS, Kantharajanna SB, Daljit S, Bachhal V, Raj N, Krishnan V, Goni V, Singh Dhillon M. Axillary artery thrombosis with anteroinferior shoulder dislocation: a rare case report and review of literature. Chin J Traumatol. 2012;15(4):244-8.
• [36] Palcau L1, Gouicem D, Dufranc J, Mackowiak E, Berger L. Delayed axillary artery pseudoaneurysm as an isolated consequence to anterior dislocation of the shoulder. Ann Vasc Surg. 2012;26(2):279.e9-12.
• [37] Karkos CD, Karamanos DG, Papazoglou KO, Papadimitriou DN, Zambas N, Gerogiannis IN, Gerassimidis TS. Axillary artery transection after recurrent anterior shoulder dislocation. Am J Emerg Med. 2010;28(1):119.e5-7.
• [38] Inui A, Fujioka H, Shoulder fracture dislocation associated with axillary artery injury: A case report J Shoulder Elbow Surg. 2009;18(2):e14-6.