Lim S M, Chua G G, Asrul F, Yazid M
Department of Orthopaedics, Universiti Sains Malaysia, Kubang Kerian, Malaysia.
Department of Orthopaedics, Hospital Tuanku Fauziah, Kangar, Malaysia.
Malays Orthop J. 2017 Nov;11(3):63-65. doi: 10.5704/MOJ.1711.008.
The brachial artery is rarely injured in closed posterior dislocation of the elbow, unlike the high rate of vascular injury seen after dislocation of the knee. Despite the anatomical proximity of the brachial artery to the elbow joint, most cases of brachial artery injury after dislocation of the elbow are related to an associated fracture, an open injury or high-energy trauma. A high index of suspicion should be maintained as well as a thorough neurovascular examination with regards this potentially disastrous complication. We describe an unusual case of complete thrombosis of the brachial artery presenting with a posterior elbow dislocation following a fall (low energy trauma) that was treated nonoperatively. At three months follow-up, patient had good circulation over the affected limb, no complaints of ischemic pain or cold intolerance, no signs of Volkmann's ischemic contracture, and a range of motion that was comparable to the contralateral limb.
与膝关节脱位后血管损伤发生率较高不同,肘关节闭合性后脱位时肱动脉很少受损。尽管肱动脉在解剖位置上与肘关节接近,但肘关节脱位后肱动脉损伤的大多数病例与合并骨折、开放性损伤或高能创伤有关。对于这种潜在的灾难性并发症,应保持高度的怀疑指数,并进行全面的神经血管检查。我们描述了一例不寻常的病例,一名患者因跌倒(低能量创伤)导致肘关节后脱位,出现肱动脉完全血栓形成,采用非手术治疗。在三个月的随访中,患者患侧肢体循环良好,无缺血性疼痛或冷不耐受的主诉,无Volkmann缺血性挛缩的迹象,活动范围与对侧肢体相当。