Enokida Shinpei, Nawata Koji, Kuroda Hiroaki, Otsuki Takeo, Nagashima Hideki
Division of Orthopedic Surgery, Department of Sensory of Motor Organs, Faculty of Medicine, Tottori University, Yonago 683-8504, Japan.
Department of Orthopedic Surgery, Eastern Shimane Medical and Welfare Center, Matsue 690-0864, Japan.
Yonago Acta Med. 2022 Apr 22;65(2):166-170. doi: 10.33160/yam.2022.05.004. eCollection 2022 May.
This report describes a rare case of brachial artery dissection associated with closed elbow dislocation caused by a snowboarding injury. After peripheral ischaemic findings in the right upper extremity were confirmed, urgent duplex-sonography was performed to diagnose the brachial artery injury. Urgent revascularisation surgery was promptly performed, and arterial dissection was diagnosed by intraoperative findings, in which the adventitia of the brachial artery was intact and the intima was disrupted. In this case, because there was no golden time window before undertaking urgent revascularisation surgery, duplex-sonography was very useful for making an emergency diagnosis. To diagnose arterial dissection, because the adventitia of the brachial artery is intact, it is necessary to perform arteriotomy to identify intimal disruption in the brachial artery. When diagnosing traumatic elbow dislocation, it is important to suspect arterial dissection.
本报告描述了一例罕见的因单板滑雪受伤导致闭合性肘关节脱位伴肱动脉夹层的病例。在确认右上肢出现外周缺血表现后,紧急进行了双功超声检查以诊断肱动脉损伤。随即迅速进行了紧急血运重建手术,术中发现诊断为动脉夹层,肱动脉外膜完整但内膜破裂。在该病例中,由于在进行紧急血运重建手术前不存在黄金时间窗,双功超声检查对于做出紧急诊断非常有用。为诊断动脉夹层,由于肱动脉外膜完整,有必要进行动脉切开术以确定肱动脉内膜破裂情况。诊断创伤性肘关节脱位时,怀疑动脉夹层很重要。