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Axillary Artery Injury Associated with Dislocated or Displaced Proximal Humeral Fracture: A Report of 3 Cases
Sadaki Mitsuzawa1, Shinnosuke Yamashita, Yoshihiro Tsukamoto
1Department of Orthopaedic Surgery, Kobe City Medical Center General Hospital, Kobe, Japan.
Case:
(1) A 69-year-old man sustained a proximal humeral fracture-dislocation. During emergency surgery, copious bleeding occurred. A pseudoaneurysm was identified 30 days postoperatively. (2) A 69-year-old man sustained a proximal humeral fracture and axillary artery injury. Physical examination demonstrated a cold but pink hand. Hemiarthroplasty and bypass vein grafting were performed. (3) An 86-year-old woman sustained a proximal humeral fracture and axillary artery injury. Her hand had turned cold and pale. Reverse shoulder arthroplasty and bypass vein grafting were performed.
Conclusion:
In cases of proximal humeral fractures with significant displacement, concomitant axillary artery injury must be assessed and if there is a high index of suspicion, prompt advanced imaging is necessary.
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1. Clinical Evaluation:
History:
Assessing Body Temperature - Axilla
Step 1: Perform hand hygiene and put on clean gloves to maintain infection control and prevent cross-contamination.
Step 2: Prepare the patient by explaining the procedure to ensure understanding and cooperation. Ensure privacy, expose the axilla, and inform the patient that minimal movement is crucial for an accurate reading.
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