Posterior elbow dislocations complicated with brachial artery rupture are rare, especially in the absence of an accompanying fracture. Severe acute ischaemia is not clearly evident in some cases and the diagnosis of arterial damage may not be realised because the collateral circulation around the elbow might mask signs of acute arterial disruption. We report a patient with brachial artery rupture due to closed posterior elbow dislocation. The diagnosis of arterial injury was delayed because the hand was well perfused and radial pulse was present at initial presentation. Our case emphasizes the need for repeated vascular examinations in elbow dislocations, moreover, hospitalisation and observation for at least 24 hours for further possible changes in the vascular status.

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