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A-neglected-closed-elbow-dislocation-with-complete-brachial-artery-injury

While brachial artery injury frequently accompanies
penetrating injuries of the elbow, open fractures,
and open dislocations of the elbow, the injury is rarely
seen with closed elbow dislocations (0.5 %) [1,2]. The
rich collateral circulation at the elbow may mask the
brachial artery injury symptoms during the early period
[3]. We treated a patient with bracial artery injury
who required treatment because of elbow dislocation a
week ago.
Case
A 64-year-old man was admitted to a medical
center after falling on his left arm in an extended position.
Closed reduction and plaster splint were applied
because of elbow dislocation. One week later, he was
admitted to our clinic because of pain, swelling, coldness,
pallor, and pulselessness of the arm. He had an ecchymosis
in the antecubital region of the elbow. Neurological
examination of the arm was normal and there
was no evidence of compartment syndrome. After posterior
elbow dislocation and brachial artery injury was
detected following radiological evaluation, the patient
was operated on urgently. With an S-shaped incision
in the anterior of the elbow, complete brachial artery
injury was observed in the extensive hematoma mass.
There was no identifiable damage in the other anatomical
structures. After the elbow was reduced, the arterial
damage was repaired with a saphenous vein graft. The
humeroulnar joint was fixed with Kirschner wire (Kwire).
At the postoperative fourth week, physcial treatment
was begun after the K-wire was removed. The
elbow range of motion (ROM) was found 10°-150° in
the postoperative third year control and there was no
cold intolerance.