Skip to main content

Advertisement

Log in

Axillary artery and brachial plexus injury after anterior shoulder dislocation: report of a case and review of the literature

  • Case Report
  • Published:
European Journal of Orthopaedic Surgery & Traumatology Aims and scope Submit manuscript

Abstract

The shoulder is the most commonly dislocated major joint of the body, but associated injury to the axillary artery and the brachial plexus has only been reported sporadically in the literature. This review presents the case of an elderly man with a recurrent dislocation, transection of the axillary artery and an associated severe brachial plexus injury. It also presents the pathognomonic triad of anterior shoulder dislocation, absent peripheral pulse and expanding axillary haematoma to raise the index of suspicion for identifying this limb-threatening injury, which demands immediate arteriography and surgical exploration. This kind of rare injury can be easily missed without a simple clinical examination.

This is a preview of subscription content, log in via an institution to check access.

Access this article

Price excludes VAT (USA)
Tax calculation will be finalised during checkout.

Instant access to the full article PDF.

Fig. 1
Fig. 2
Fig. 3

Similar content being viewed by others

References

  1. Androulakakis Z, Zavras TD, Androulidakis E (2004) Insidious presentation of axillary artery branch avulsion after trivial blunt trauma. Injury 35:1211–1213

    Article  PubMed  Google Scholar 

  2. Baratta JB, Lim V, Mastromonaco E, Edillon EL (1983) Axillary artery disruption secondary to anterior dislocation of the shoulder. J Trauma 23:1009–1011

    PubMed  CAS  Google Scholar 

  3. Dolk T, Stenberg B (1991) Arterial injury in fracture dislocation of the shoulder. Acta Orthop Scan 62:17

    Article  Google Scholar 

  4. Gates JD, Knox JB (1995) Axillary artery injuries secondary to anterior dislocation of the shoulder. J Trauma 39:581–583

    PubMed  CAS  Google Scholar 

  5. Goubier JN, Duranthon LD, Vandenbussche E et al (2004) Anterior dislocation of the shoulder with rotator cuff injury and brachial plexus palsy: a case report. J Shoulder Elbow Surg 13:362–363

    Article  PubMed  Google Scholar 

  6. Guvener M, Kaplan S, Demircin M, Pasaoglu I (2000) Axillary artery injury: an isolated, delayed case after blunt trauma of the upper limb. J Trauma 48:951–953

    PubMed  CAS  Google Scholar 

  7. Helm AT, Watson JS (2002) Compression of the brachial plexus in a patient with false aneurysm of the axillary artery as a result of anterior shoulder dislocation. J Shoulder Elbow Surg 11:278–279

    Article  PubMed  Google Scholar 

  8. Jardon OM, Hood LT, Lynch RD (1973) Complete avulsion of the axillary artery as a complication of shoulder dislocation. J Bone Joint Surg Am 55:189–192

    PubMed  CAS  Google Scholar 

  9. Kelley SP, Hinsche AF, Hossain JF (2004) Axillary artery transection following anterior shoulder dislocation: classical presentation and current concepts. Injury 35:1128–1132

    Article  PubMed  CAS  Google Scholar 

  10. Lin CY, Chen SJ, Yu CT, Chang IL (2007) Simultaneous bilateral anterior fracture dislocation of the shoulder with neurovascular injury: report of a case. Int Surg 92:89–92

    PubMed  Google Scholar 

  11. Liveson JA (1984) Nerve lesions associated with shoulder dislocation; an electrodiagnostic study of 11 cases. J Neurol Neurosurg Psychiatry 47:742–744

    Article  PubMed  CAS  Google Scholar 

  12. MacNamara AF, Ismail A (2000) Combined brachial plexus and vascular injury in the absence of bony injury. J Accid Emerg Med 17:378–379

    PubMed  CAS  Google Scholar 

  13. McLaughlin HL, MacLellan DI (1967) Recurrent anterior dislocation of the shoulder. II. A comparative study. J Trauma 7:191–201

    PubMed  CAS  Google Scholar 

  14. Milton GW (1953) The mechanism of circumflex and other nerve injuries in dislocation of the shoulder and the possible mechanism of nerve injuries during reduction of dislocation. Aust N Z J Surg 23:25–30

    Article  PubMed  CAS  Google Scholar 

  15. Mumenthaler M, Schliak H (1965) Lasionen peripheren nerven. Georg Thiem Verlag, Stuttgart

    Google Scholar 

  16. Murata K, Maeda M, Yoshida A et al (2008) Axillary artery injury combined with delayed brachial plexus palsy due to compressive hematoma in a young patient: a case report. J Brachial Plex Peripher Nerve Inj 3:9

    Article  PubMed  Google Scholar 

  17. Pasila M, Kiviluoto O, Jaroma H, Sundholm A (1980) Recovery from primary shoulder dislocation and its complications. Acta Orthop Scand 51:257–262

    Article  PubMed  CAS  Google Scholar 

  18. Rockwood CJ, Green D (1996) Fractures in adults, 4th edn. Lippincott-Raven, Philadelphia

    Google Scholar 

  19. Rowe CR (1978) Instabilities of the glenohumeral joint. Bull Hosp Joint Dis 39:180–186

    PubMed  CAS  Google Scholar 

  20. Volpin G, Langer R, Stein H (1990) Complete infraclavicular brachial plexus palsy with occlusion of axillary vessels following anterior dislocation of the shoulder joint. J Orthop Trauma 4:121–123

    PubMed  CAS  Google Scholar 

  21. Watson-Jones R (1936) Dislocation of the shoulder joint. Proc R Soc Med 29:1060–1062

    Google Scholar 

  22. Watson-Jones R (1957) Fractures and joint injuries, 4th edn. Williams & Wilkins, Baltimore

    Google Scholar 

  23. Witz M (2003) Transected axillary artery: unusual blunt trauma. J Trauma 54:203

    PubMed  Google Scholar 

Download references

Conflict of interest statement

No funds were received in support of this study.

Author information

Authors and Affiliations

Authors

Corresponding author

Correspondence to Vassilios S. Nikolaou.

Rights and permissions

Reprints and permissions

About this article

Cite this article

Nikolaou, V.S., Pilichou, A., Staramos, D. et al. Axillary artery and brachial plexus injury after anterior shoulder dislocation: report of a case and review of the literature. Eur J Orthop Surg Traumatol 18, 595–598 (2008). https://doi.org/10.1007/s00590-008-0357-y

Download citation

  • Received:

  • Accepted:

  • Published:

  • Issue Date:

  • DOI: https://doi.org/10.1007/s00590-008-0357-y

Keywords

Navigation