DOI: http://dx.doi.org/10.18203/issn.2455-4510.IntJResOrthop20175668

The management of a complex elbow injury with transection of the brachial artery

Supreeth Nekkanti, Arunodhaya Siddartha, Purushotham Sastry, Prakash M., Anubhav Verma

Abstract


Elbow dislocations are commonly encountered cases by orthopaedic surgeon. Vascular injury accompanying an elbow dislocation is a surgical challenge. The authors report a rare complication of complete transaction of the brachial artery following a posterior dislocation of the elbow joint. A fifty-year old male suffered a road traffic accident during which he injured his left elbow. Radiographs confirmed a posterior dislocation of the elbow joint. However the radial and ulnar pulse very not palpable. Arterial doppler confirmed injury to brachial artery. The patient was successfully treated and regained full functional use of his left upper limb. The aim of this report is to help readers understand why a vascular injury occurs following an elbow dislocations. A successful management of such injuries revolves around a prompt clinical diagnosis and early repair.


Keywords


Elbow dislocation, Brachial artery transaction, Posterior dislocation, Vascular injury, Complex elbow trauma

Full Text:

PDF

References


Ayela JE, Bonnevialle N, Lafosse JM, Pidhorz L, Al Homsy M, Mansat P, et al. Acute elbow dislocation with arterial rupture. Analysis of nine cases Orthop Traumatol Surg Res. 2009;95:343-51.

Moneim MS, Garst JR. Vascular injuries associated with elbow fractures and dislocations. Int Angiol. 1995;14:307-12.

Sparks SR, Delarosa J, Bergan JJ, Hoyt DB, Owens EL. Arterial injury in uncomplicated upper extremity dislocations. Ann Vasc Surg. 2000;14:110-3.

Bonnevialle P, Chauffour X, Loustau O, Mansat P, Pidhorz L, Mansat M. Luxations traumatiques du genou associées à une interruption de l’artère poplitée : étude critique retrospective d’une série de 14 cas. Rev Chir Orthop. 2006;92:768-77.

Lobenhoffer P, Tscherne H: Definition of complex trauma and general management principles. Orthopade. 1997;26:1014-9.

Bain GI. A review of complex trauma to the elbow. Aust N Z J Surg. 1999;69:578-81.

Simpson NS, Jupiter JB: Complex fracture patterns of the upper extremity. Clin Orthop. 1995;318:43-53.

Regel G, Weinberg AM, Seekamp A, Blauth M, Tscherne H. Complex trauma of the elbow. Orthopade. 1997;26:1020-9.

Josefsson PO, Nilsson BE. The incidence of elbow dislocation. Acta Orthop Scand. 1986;57:537-8.

Endean ED, Veldenz HC, Schwarcz TH, Hyde GL. Recognition of arterial injury in elbow dislocation. J Vasc Surg. 1992;16:402—6.

Moneim MS, Garst JR. Vascular injuries associated with elbow fractures and dislocations. Int Angiol. 1995;14:307-12.

Sparks SR, Delarosa J, Bergan JJ, Hoyt DB, Owens EL. Arterial injury in uncomplicated upper extremity dislocations. Ann Vasc Surg. 2000;14:110-3.

Kazakos J, Galanis VG. Unusual patterns of Monteggia fracture-dislocation. J Orthopaedic Surg Res. 2006, 1:12

Eijer H, Ballmer FT, Ris HB, Hertel R. Delayed diagnosis of a ruptured brachial artery after posterior dislocation of the elbow. Injury. 1998;29:390–2.

Alonso JA, Roy BR, Shaw DL. Open anterolateral dislocation of the elbow. A case report. BMC Musculoskeletal Dis. 2002;3:1.