Delayed Radial Nerve Injury from a Brachial Artery Pseudoaneurysm Following a Four-Part Proximal Humerus Fracture: A...

Following a 4-part proximal humerus fracture at the level of the surgical neck, an 84-year-old woman presented with delayed radial nerve deficits secondary to a brachial artery pseudoaneurysm. She underwent emergent repair of the vessel and reverse total shoulder arthroplasty. The deficit remained present at 1-year follow-up and is unlikely to improve.

Brachial artery pseudoaneurysms can occur following humeral fractures. Fractures at this location can lead to the unique complication of a proximal pseudoaneurysm that compresses the radial nerve. It should be considered a possible limb-threatening complication in fractures managed conservatively as well as surgical candidates.