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肩部骨折脱位后桡动脉搏动正常但腋动脉损伤：一例报告

Axillary Artery Injury with Intact Radial Pulse following Fracture-Dislocation of Shoulder: A Case Report.

作者信息

Rajeev A, Timmons G

机构信息

Department of Orthopaedics, Gateshead Health NHS Foundation Trust, Gateshead, United Kingdom.

Department of Radiology, Gateshead Health NHS Foundation Trust, Gateshead, United Kingdom.

出版信息

Malays Orthop J. 2019 Nov;13(3):66-68. doi: 10.5704/MOJ.1911.011.

DOI:10.5704/MOJ.1911.011
PMID:31890113
原文链接:https://pmc.ncbi.nlm.nih.gov/articles/PMC6915319/
Abstract

The occurrence of axillary artery injury following proximal humerus fracture dislocation in elderly patient with low velocity fall is uncommon. The patient could have diverse clinical presentations in spite of intact peripheral pulses. We report the case of an 85-year-old lady who presented to our emergency department with greater tuberosity fracture of the humerus with dislocation of the right shoulder. After closed manipulative reduction of the dislocation, it was observed that the patient had brachial plexus palsy with intact radial pulse. An expanding swelling and bruise around the shoulder was noted and a steady drop in haemoglobin level. CT angiogram revealed avulsion of the posterior circumflex artery which was then treated successfully with stenting.

摘要

老年患者因低速跌倒导致肱骨近端骨折脱位后发生腋动脉损伤的情况并不常见。尽管外周脉搏正常，患者仍可能有多种临床表现。我们报告了一例85岁女性患者，她因肱骨大结节骨折伴右肩关节脱位就诊于我院急诊科。在对脱位进行闭合手法复位后，发现患者存在臂丛神经麻痹，但桡动脉搏动正常。注意到肩部周围有肿胀和瘀斑扩大，血红蛋白水平持续下降。CT血管造影显示旋肱后动脉撕脱，随后通过支架置入成功治疗。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/637e/6915319/d497a9b03858/moj-13-066-f3.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/637e/6915319/3b98296367e1/moj-13-066-f1.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/637e/6915319/c9ba461a8287/moj-13-066-f2.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/637e/6915319/d497a9b03858/moj-13-066-f3.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/637e/6915319/3b98296367e1/moj-13-066-f1.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/637e/6915319/c9ba461a8287/moj-13-066-f2.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/637e/6915319/d497a9b03858/moj-13-066-f3.jpg

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本文引用的文献

1
Axillary artery and brachial plexus injury secondary to proximal humeral fractures: A report of 2 cases.肱骨近端骨折继发腋动脉及臂丛神经损伤：2例报告
Int J Surg Case Rep. 2018;50:106-110. doi: 10.1016/j.ijscr.2018.04.044. Epub 2018 Jul 25.
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Axillary artery injury as a complication of proximal humerus fractures.腋动脉损伤作为肱骨近端骨折的一种并发症。
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