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锁骨骨折后迟发性并发症:锁骨下动脉假性动脉瘤。

Pseudoaneurysm of the subclavian artery as a delayed complication of a clavicle fracture.

机构信息

Family Medicine, University of Colorado Denver School of Medicine, Denver, Colorado, USA.

Family Medicine and Orthopedics, University of Colorado Denver School of Medicine, Denver, Colorado, USA

出版信息

BMJ Case Rep. 2023 May 2;16(5):e252430. doi: 10.1136/bcr-2022-252430.

Abstract

Vascular complications are relatively rare following surgical fixation of midshaft clavicle fractures. Here, we report a case of a woman in her 30s presenting 10 years after right clavicular open reduction and internal fixation with revision 6 years prior with sudden and rapidly progressive neck swelling. Physical examination revealed a soft pulsating mass in her right supraclavicular fossa. Ultrasound and CT angiography of the head and neck showed a pseudoaneurysm of her right subclavian artery with a surrounding haematoma. She was admitted to the vascular surgery team for endovascular repair with stenting. Postoperatively, she developed arterial thrombi requiring thrombectomy (twice) and is now on lifelong anticoagulation. It is crucial to be aware of complications that can develop in patients with a history of clavicular fracture managed non-operatively or operatively even years later and highlights the importance of risk and benefit discussions and counselling.

摘要

血管并发症在外科固定锁骨中段骨折后相对较少见。在这里,我们报告了一名 30 多岁女性的病例,她在右侧锁骨开放性复位和内固定术后 10 年,此前 6 年前进行了翻修,突然出现并迅速进展的颈部肿胀。体格检查显示其右锁骨上窝有一个柔软的搏动性肿块。头颈部的超声和 CT 血管造影显示其右侧锁骨下动脉假性动脉瘤伴周围血肿。她被收入血管外科团队进行血管内修复和支架置入。术后,她出现动脉血栓形成,需要进行两次血栓切除术,现在需要终身抗凝治疗。了解即使在数年之后,有锁骨骨折病史的患者可能会出现的并发症至关重要,这突出了风险和益处讨论和咨询的重要性。

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