Transection of the brachial artery after closed posterior elbow dislocation

Abstract

Although elbow dislocations are common orthopaedic lesions, vascular complications remain rare. We report the cases of three patients who presented with a rupture of the brachial artery after closed posterior dislocation, which is even more uncommon. Arteriograms were performed in all cases because of the persistent absence of pulses at the wrist after emergency reduction. In each patient, the treatment consisted of the insertion of reversed end-to-end saphenous bridges. None of them presented mid-term vascular complications (mean follow-up, 17 months). Brachial artery disruption can result from closed posterior elbow dislocation and responds well to vascular repair.

Arterial damages in acute elbow dislocations: which diagnostic tests are required?

“…However, as angiography and surgical examination did not show a total occlusion, dissection or disruption of the vessel, we believe that the filiform stenosis was caused by a compression of the haematoma and/or a thrombosis following the trauma. As the periarticular arterial collateral system is relatively strong, a radial pulse and sufficient oxygenation of the forearm and the hand can often be detected even if the brachial artery is acutely occluded or disrupted 9. However, swelling of the periarticular tissue can cause compression on the collateral network after the trauma, which sometimes induces a delayed ischaemia 1.…”

“…In contrast to the formerly recommended ligature of the affected vessel,9 today's standard procedure is rapid recanalisation of the occluded or disrupted artery to avoid secondary ischaemia or ischaemic symptoms under exercise 1…”

Brachial artery transection associated with open elbow dislocation in a 12-year-old: a case report

“…10 Both emergency room physicians and orthopedic surgeons play a vital role with regard to the initial evaluation and treatment of these patients. One of the most important roles of the emergency room physician and orthopedic surgeon with individuals presenting with elbow dislocations is the evaluation for concomitant vascular injuries.…”

Simple Posterior Elbow Dislocation and Brachial Artery Transection

“…It is the most commonly dislocated joint in children [1] and the second most common in adults [2]. Approximately half are sports injuries [2] but other prominent causes include motorcycle incidents and falling from a height [3,4]. They are classified according to whether there is an accompanying fracture (complex; 26% of cases) or not (simple; 74% of cases) and the direction of dislocation which is anterior in 4% of cases or posterior/posterolateral in the rest [2].…”