Nonoperative Management of Subclavian Artery Thrombosis in Pediatric Clavicle Fractures

Lyons, Madeline M; Holzmeister, Adam M.; Cappello, Teresa

doi:10.2106/jbjs.cc.20.00815

Cited by 2 publications

(1 citation statement)

References 9 publications

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“…Palpation pain in the vicinity of the brachial vein (palpation tenderness of the medial bicipital groove) was also observed in our patients (9). In case of subclavian vascular bundle compression, acute limb ischaemia (poor palpable pulsation, paleness, decreased skin temperature, suddenly increased pain, peripheral paraesthesia, peripheral movement disorder, peripheral sensitivity dysfunction) may also be signs of vascular thoracic outlet syndrome, in case of suspicion of possible limb ischaemia, examination by a vascular surgeon is emergently required (3)(4)(5)(6)(7)9).…”

Section: Discussionmentioning

confidence: 99%

Deep Venous Thrombosis after Conservative Treatment of Clavicular Fracture in COVID-19 Negative Children: Two Case Reports

Salášek¹,

Pavelka²,

Weisová³

2022

ACHOT

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A 13-year-old girl suffered fracture of her left clavicle. A figure-of-8 bandage was placed during initial treatment. Six days after trauma her distal arm, elbow and proximal forearm were swollen, pain and tenderness of distal part of brachial vein was recognized during clinical examination. Duplex ultrasonography revealed partial thrombosis of the brachial vein. Bandage was immediately removed and administration of LMWH (enoxaparin) was started. Complete recanalization was achieved after a few days. The fracture was healed without further complication, patient was without sonographic and clinical signs of post-thrombotic syndrome. The second case report describes a 14-year-old boy. Initially, the fixation was a figure-of-8 bandage. 5 days after the injury he had swollen arm and elbow on the injured side, according to duplex ultrasonography deep venous thrombosis of the axillary and the brachial vein was recognized. There was only partial recanalization at the first sonographic follow up, the patient was converted to Warfarin for 3 months after injury after initial LMWH therapy. At the last follow-up, fracture of the left clavicle was healed and there were no DUSG or clinical signs of post-thrombotic syndrome.

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Section: Discussionmentioning

confidence: 99%

Deep Venous Thrombosis after Conservative Treatment of Clavicular Fracture in COVID-19 Negative Children: Two Case Reports

Salášek¹,

Pavelka²,

Weisová³

2022

ACHOT

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Subclavian vessels injury: An underestimated complication of clavicular fractures

Chalidis,

Davitis,

Papadopoulos

et al. 2024

World J Crit Care Med

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Clavicle fractures are frequent orthopedic injuries, often resulting from direct trauma or a fall. Most clavicle fractures are treated conservatively without any complications or adverse effects. Concomitant injuries of the subclavian vein or artery are rarely encountered and most commonly associated with high-energy trauma or comminuted clavicle fractures. They are potentially life-threatening conditions leading to hemorrhage, hematoma, pseudoaneurysm or upper limb ischemia. However, the clinical presentation might be obscure and easily missed, particularly in closed and minimally displaced clavicular fractures, and timely diagnosis relies on early clinical suspicion. Currently, computed tomography angiography has largely replaced conventional angiography for the assessment of subclavian vessel patency, as it demonstrates high accuracy and temporal resolution, acute turnaround time, and capability of multiplanar reconstruction. Depending on the hemodynamic stability of the patient and the severity of the injury, subclavian vessel lesions can be treated conservatively with observation and serial evaluation or operatively. Interventional vascular techniques should be considered in patients with serious hemorrhage and limb ischemia, followed by stabilization of the displaced clavicle fracture. This review aims to provide a comprehensive overview of the incidence, clinical presentation, diagnostic approaches, and current management strategies of clavicle fractures associated with subclavian vessel injuries.

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Nonoperative Management of Subclavian Artery Thrombosis in Pediatric Clavicle Fractures

Cited by 2 publications

References 9 publications

Deep Venous Thrombosis after Conservative Treatment of Clavicular Fracture in COVID-19 Negative Children: Two Case Reports

Deep Venous Thrombosis after Conservative Treatment of Clavicular Fracture in COVID-19 Negative Children: Two Case Reports

Subclavian vessels injury: An underestimated complication of clavicular fractures

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