Dog bite causing ischemia and neurological deficit at the upper extremity: a case report

Area of Science:

• Trauma Surgery
• Vascular Surgery
• Neurology

Background:

• Dog bites can cause severe upper extremity trauma, including vascular compromise and nerve damage.
• Brachial artery occlusion and combined median and radial nerve injuries are exceptionally rare sequelae of canine attacks.
• Prompt diagnosis and management are crucial for limb salvage and functional recovery.

Purpose of the Study:

• To report an unusual case of combined brachial artery occlusion and median/radial nerve injury following a dog bite.
• To highlight the diagnostic and therapeutic challenges in managing such complex trauma.
• To emphasize the importance of a multidisciplinary approach in treating severe extremity injuries.

Main Methods:

• A 26-year-old male presented with a dog bite to the left arm, exhibiting finger weakness.
• Physical examination revealed absent brachial and radial pulses, and neurological deficits in median and radial nerves.
• Diagnostic workup included laboratory and radiological evaluations, followed by emergency thromboembolectomy. Nerve injuries were treated medically.

Main Results:

• The patient underwent successful thromboembolectomy to restore brachial artery patency.
• Neurological examination confirmed partial median and radial nerve deficits.
• Medical treatment was initiated for the nerve injuries.

Conclusions:

• This case underscores the potential for severe vascular and neurological complications from dog bites.
• Aggressive and timely surgical intervention (thromboembolectomy) is vital for limb viability.
• Management of associated nerve injuries requires careful evaluation and appropriate medical therapy.