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闭合性肘关节脱位伴肱动脉损伤。

Brachial artery injury accompanying closed elbow dislocations.

作者信息

Harnarayan Patrick, Cawich Shamir O, Harnanan Dave, Budhooram Steve

机构信息

Department of Clinical Surgical Sciences, Faculty of Medicine, University of the West Indies, St. Augustine Campus, Trinidad and Tobago.

Department of Clinical Surgical Sciences, Faculty of Medicine, University of the West Indies, St. Augustine Campus, Trinidad and Tobago.

出版信息

Int J Surg Case Rep. 2015;8C:100-2. doi: 10.1016/j.ijscr.2014.12.009. Epub 2014 Dec 12.

Abstract

INTRODUCTION

Brachial artery injuries from elbow dislocations are uncommon, but they may lead to disastrous consequences if the diagnosis is delayed.

PRESENTATION OF CASE

We report a case of a patient who sustained a fall onto the elbow, with dislocation and brachial artery injury, despite an ipsilateral radial pulse being palpable.

DISCUSSION

Clinicians should maintain a high index of suspicion for brachial injury when patients present with a fall onto the elbow coupled with signs suggestive of fracture-dislocation, nerve injury and/or signs of limb ischemia. Frank ischamia, however, is uncommon as there is a rich collateral anastomosis in the upper limb.

CONCLUSION

A high index of suspicion should be maintained in order to make the diagnosis early. Exploration with excision of the injured segment and reverse vein interposition grafting is the treatment of choice in these cases.

摘要

引言

肘关节脱位导致的肱动脉损伤并不常见,但如果诊断延误可能会导致灾难性后果。

病例介绍

我们报告一例患者,其肘部着地摔倒,伴有脱位和肱动脉损伤,尽管同侧桡动脉搏动可触及。

讨论

当患者肘部着地摔倒并伴有提示骨折脱位、神经损伤和/或肢体缺血迹象时,临床医生应高度怀疑肱动脉损伤。然而,明显的缺血并不常见,因为上肢有丰富的侧支吻合。

结论

应保持高度怀疑以早期做出诊断。在这些病例中,选择的治疗方法是探查并切除损伤段,然后进行静脉逆行移植。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/3579/4353976/67ed11f89e33/gr1.jpg

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