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Brachial artery injury accompanying closed elbow dislocations
Patrick Harnarayan1, Shamir O Cawich1, Dave Harnanan1
1Department of Clinical Surgical Sciences, Faculty of Medicine, University of the West Indies, St. Augustine Campus, Trinidad and Tobago.
Introduction:
Brachial artery injuries from elbow dislocations are uncommon, but they may lead to disastrous consequences if the diagnosis is delayed.
Presentation Of Case:
We report a case of a patient who sustained a fall onto the elbow, with dislocation and brachial artery injury, despite an ipsilateral radial pulse being palpable.
Discussion:
Clinicians should maintain a high index of suspicion for brachial injury when patients present with a fall onto the elbow coupled with signs suggestive of fracture-dislocation, nerve injury and/or signs of limb ischemia. Frank ischamia, however, is uncommon as there is a rich collateral anastomosis in the upper limb.
Conclusion:
A high index of suspicion should be maintained in order to make the diagnosis early. Exploration with excision of the injured segment and reverse vein interposition grafting is the treatment of choice in these cases.
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