Brachial artery pseudoaneurysm, a late complication of humeral non-union
- نوع فایل : کتاب
- زبان : انگلیسی
- مؤلف : Ayman Gabr Gunasekaran Kumar Badri Narayan
- چاپ و سال / کشور: 2010
Description
Introduction We present a case of a pseudoaneurysm of the brachial artery arising due to a bone spike of a mobile non-union of a fracture of the humerus. Case history An 87 years old lady presented with a sudden increase in the size of a 5 weeks old swelling in her left arm. Patient had sustained a humeral shaft fracture 4 years back that was treated non-operatively. This had evolved into a painless and mobile non-union. A decision for continuing non-operative management had been taken. She had been discharged from active care at that stage. Examination revealed a pulsatile swelling on the medial side of the left arm. Plain radiographs showed a large soft tissue shadow surrounding the proximal third shaft humeral non-union with widely displaced fragments. A CT angiogram of the left subclavian artery showed a 16 9 15 9 12 cm pseudoaneurysm arising from the brachial artery. The sharp edge of the distal end of the proximal humeral fragment was in contact with the pseudoaneurysm sac. She underwent excision of the pseudoaneurysm sac and vein patch graft. Humeral non-union was stabilised with an anterior 10-holed large fragment locking plate. The extent of surgery and medical co-morbidities resulted in a deterioration of her medical condition, and she succumbed to these about 2 days postoperatively. Conclusion This case makes an argument for follow-up of long-bone non-unions, more so when the fracture ends have spikes and widely displaced.
Eur J Orthop Surg Traumatol (2011) 21:123–126 DOI 10.1007/s00590-010-0673-x Received: 22 March 2010 / Accepted: 24 June 2010 / Published online: 15 July 2010
