Panagiotopoulos Elias, Athanaselis Efstratios, Matzaroglou Charalampos, Kasimatis Georgios, Gliatis John, Tsolakis Ioannis
J Med Case Rep. 2009 Jun 5;3:6627. doi: 10.4076/1752-1947-3-6627.
A patient with a neglected, compound acutely ruptured false aneurysm of the brachial artery which developed after a periprosthetic fracture of the right humerus, is reported.
An 84-year-old Greek woman underwent right shoulder hemiarthroplasty 2 years before a periprosthetic fracture which was treated conservatively in another hospital. After removing the U-slab herself, she noticed the development of an ulcer on the mid-humerus, with continuous oozing but no fever. This led to above-elbow amputation in an attempt to save the patient's life.
It is hoped that by awareness of such a possibility coupled with an early diagnosis based on the clinical picture and imaging modalities, such unfortunate results can be avoided in the future. In case of increasing displacement at the fracture site and excessive local swelling, the possibility of the presence of a false brachial aneurysm should be ruled out despite the presence of normal perfusion of the hand and palpable radial and ulnar pulses.
本文报道了一名患者，其在右肱骨假体周围骨折后出现了被忽视的、复合性急性破裂肱动脉假性动脉瘤。
一名84岁的希腊女性在假体周围骨折前2年接受了右肩关节半关节置换术，该骨折在另一家医院接受了保守治疗。她自行拆除U型石膏后，注意到肱骨中部出现溃疡，有持续渗液但无发热。为挽救患者生命，最终进行了肘上截肢。
希望通过认识到这种可能性，并基于临床表现和影像学检查进行早期诊断，未来能够避免此类不幸结果。在骨折部位移位增加且局部肿胀过度的情况下，尽管手部血供正常且可触及桡动脉和尺动脉搏动，也应排除肱动脉假性动脉瘤的存在。
