Axillary artery compromise in a minimally displaced proximal humerus fracture: a case report

Minimally displaced fractures of the surgical neck of the humerus are rarely associated with axillary artery injury. The innocuous appearance of the x-rays can be misleading and a missed arterial injury in these fractures could potentially lead to disastrous consequences. We report the case of a patient who sustained a minimally displaced fracture of the proximal humerus with vascular compromise requiring immediate investigation and referral to vascular surgeons. Despite spontaneous resolution of the vascular insult, it is important to remember the association of such fractures with vascular injuries in order to diagnose them early and prevent serious complications including amputation

Use of a Javid™ shunt in the management of axillary artery injury as a complication of fracture of the surgical neck of the humerus: a case report

<p>Abstract</p> <p>Introduction</p> <p>Axillary artery injury is a rare but severe complication of fractures of the surgical neck of the humerus.</p> <p>Case presentation</p> <p>We present a case of axillary artery pseudoaneurysm secondary to such a fracture, in a 82-year-old white woman, presenting 10 weeks after the initial injury, successfully treated with subclavian to brachial reversed vein bypass together with simultaneous open reduction and internal fixation of the fracture. We discuss the use of a Javid™ shunt during combined upper limb revascularisation and open reduction and internal fixation of the fractured humerus.</p> <p>Conclusion</p> <p>This case highlights the usefulness of a Javid™ shunt, over other forms of vascular shunts, in prompt restoration of blood flow to effect limb salvage. It can be considered as a temporary measure whilst awaiting definitive revascularisation which can be performed following fracture fixation.</p