Skip to main content

Advertisement

Log in

Recurrent peripheral embolism following nonunion of the clavicle

  • Case Report
  • Published:
Indian Journal of Orthopaedics Aims and scope Submit manuscript

Abstract

Vascular complications in closed clavicular fractures are uncommon, with an incidence of only 0.4%. Subclavian artery injury can present acutely or can have a delayed presentation with arm ischemia. We report the case of an undetected subclavian pseudoaneurysm in a patient with a nonunion fracture clavicle who was referred with persistent ischemia following attempted brachial embolectomy at another center, along with a review of literature to support the hypothesis that in addition to repair of the aneurysm, treatment of the psuedarthrosis by fixation of the clavicle is essential.

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.

Similar content being viewed by others

References

  1. Brinker MR, Edwards TB, O’Connor DP. Estimating the risk of nonunion following nonoperative treatment of a clavicular fracture. J Bone Joint Surg Am 2005;87:676–7.

    Article  Google Scholar 

  2. Ballmer FT, Lambert SM, Hertel R. Decortication and plate osteosynthesis for nonunion of the clavicle. J Shoulder Elbow Surg 1998;7:581–5.

    Article  CAS  Google Scholar 

  3. Altamimi SA, McKee MD. Canadian Orthopaedic Trauma Society. Nonoperative treatment compared with plate fixation of displaced midshaft clavicular fractures. Canadian Orthopaedic Trauma Society 2008;90 Suppl 2 Pt 1:1–8.

    Google Scholar 

  4. Khan LA, Bradnock TJ, Scott C, Robinson CM. Fractures of the clavicle. J Bone Joint Surg Am 2009;91:447–60.

    Article  Google Scholar 

  5. Demetriades D, Asensio JA. Subclavian and axillary vascular injuries. Surg Clin North Am 2001;81:1357–73.

    Article  CAS  Google Scholar 

  6. Coulier B, Mairy Y, Etienne PY, Joris JP. Late diagnosis of a traumatic pseudo-aneurysm of the subclavian artery. J Belge Radiol 1996;79:26–8.

    CAS  PubMed  Google Scholar 

  7. Serrano JA, Rodríguez P, Castro L, Serrano P, Carpintero P. Acute subclavian artery pseudoaneurysm after closed fracture of the clavicle. Acta Orthop Belg 2003;69:555–7.

    PubMed  Google Scholar 

  8. Burnand KM, Lagocki S, Lahiri RP, Tang, TY, Patel AD, Clarke JM. Persistent subclavian artery tenosis following surgical repair of nonunion of a fractured clavicle. Grand Rounds, Specialty-Vascular Surgery 2010;10:55–8.

    Google Scholar 

  9. Bukhari HA, Saadia R, Hardy BW. Urgent endovascular stenting of subclavian artery pseudoaneurysm caused by seatbelt injury. Can J Surg 2007;50:303–4.

    PubMed  PubMed Central  Google Scholar 

  10. Garnier D, Chevalier J, Ducasse E, Modine T, Espagne P, Puppinck P. Arterial complications of thoracic outlet syndrome and pseudarthrosis of the clavicle: Three patients. J Mal Vasc 2003;28:79–84.

    CAS  PubMed  Google Scholar 

  11. Andersen JR, Willis MP, Nelson R, Mighell MA. Precontoured superior locked plating of distal clavicle fractures: A new strategy. Clin Orthop Relat Res 2011;469:3344–50.

    Article  Google Scholar 

  12. VanBeek C, Boselli KJ, Cadet ER, Ahmad CS, Levine WN. Precontoured plating of clavicle fractures: Decreased hardware-related complications? Clin Orthop Relat Res 2011;469:3337–43.

    Article  Google Scholar 

  13. Böstman O, Manninen M, Pihlajamäki H. Complications of plate fixation in fresh displaced midclavicular fractures. J Trauma 1997;43:778–83.

    Article  Google Scholar 

  14. Shackford SR, Connolly JF. Taming of the screw: A case report and literature review of limb-threatening complications after plate osteosynthesis of a clavicular nonunion. J Trauma 2003;55:840–3.

    Article  Google Scholar 

Download references

Author information

Authors and Affiliations

Authors

Corresponding author

Correspondence to Viju Daniel Varghese.

Rights and permissions

Reprints and permissions

About this article

Check for updates. Verify currency and authenticity via CrossMark

Cite this article

Sen, I., Varghese, V.D., Stephen, E. et al. Recurrent peripheral embolism following nonunion of the clavicle. IJOO 48, 329–331 (2014). https://doi.org/10.4103/0019-5413.132530

Download citation

  • Published:

  • Issue Date:

  • DOI: https://doi.org/10.4103/0019-5413.132530

Key words

Navigation