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Case Report
- Delayed Subclavian Vein Stenosis without Thrombosis Following Clavicle Fracture
- Do Wan Kim, In Seok Jeong, Kook Joo Na
- J Trauma Inj. 2019;32(4):243-247. Published online December 30, 2019
- DOI: https://doi.org/10.20408/jti.2019.024
- 3,517 View
- 50 Download
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Abstract
PDF Subclavian vein injuries occasionally occur as a sequela of penetrating trauma or vascular access, but have rarely been reported to occur after clavicle fracture. The subclavian vessels are mainly enclosed by the subclavius muscle, the first rib, and the costocoracoid ligament. Therefore, in such cases, subclavian vein injury is rare because of the strcutures surrounding the subclavian vessels. Nevertheless, subclavian vein injuries occasionally show thrombotic manifestations, and thrombosis of the upper limbs constitutes 1–4% of cases of total deep vein thrombosis. Furthermore, to the best of the authors’ knowledge, although vessel injuries have been reported after clavicle or rib fractures and nerve injuries to regions such as the brachial plexus, no case involving delayed presentation of isolated subclavian vein stenosis after clavicle fracture due to blunt trauma has yet been reported.
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SummaryOriginal Article
- Operative Treatment for Midshaft Clavicle Fractures in Adults: A 10-Year Study Conducted in a Korean Metropolitan Hospital
- Jeong Kook Baek, Young Ho Lee, Min Bom Kim, Goo Hyun Baek
- J Trauma Inj. 2016;29(4):105-115. Published online December 31, 2016
- DOI: https://doi.org/10.20408/jti.2016.29.4.105
- 2,570 View
- 27 Download
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Abstract
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- PURPOSE
While all midshaft clavicle fractures have traditionally been treated with conservative measures, recent operative treatment of displaced, communited midshaft clavicle fractures has become more common. Though a recent increase in operative treatment for midshaft clavicle fractures, we have done the operative methods in limited cases. The aim of this study is to present indications, operative techniques and outcomes of the experienced cases that have applied to this limited group over the previous 10 years.
METHODS
This study consists of a retrospective review of radiological and clinical data from January of 2005 to July of 2015. Operative criteria for midshaft clavicle fractures having considerable risk of bone healing process were 4 groups - a floating shoulder, an open fracture, an associated neurovascular injury, and a nonunion case after previous treatment.
RESULTS
The study consisted of 18 patients who had operative treatment for midshaft clavicle fractures in adults. The most common surgical indication was a floating shoulder (10 cases, 55.6%), followed by nonunion (5 cases, 27.8%), an associated neurovascular injury (4 cases, 22.2%), and open fracture (3 cases, 16.7%). All cases were treated by open reduction and internal fixation in anterosuperior position with reconstruction plate or locking compression plate. Bone union was achieved in all cases except 1 case which was done bone resection due to infected nonunion. Mean bone union period was 19.5 weeks. There were no postoperative complications, but still sequelae in 4 cases of brachial plexus injury.
CONCLUSION
We have conducted an open reduction and internal fixation by anterosuperior position for midshaft clavicle fractures in very limited surgical indications for last 10 years. Our treatment strategy for midshaft clavicle fractures showed favorable radiological results and low postoperative complications. -
SummaryCase Report
- Traumatic Subclavian Artery Dissection in Clavicle Fracture Due to Blunt Injury: Surgery or Stent in Long Segment Occlusion?
- Soon Ho Chon, Kilsoo Yie, Jae Gul Kang
- J Trauma Inj. 2015;28(3):219-221. Published online September 30, 2015
- DOI: https://doi.org/10.20408/jti.2015.28.3.219
- 1,759 View
- 11 Download
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Abstract
PDF
- Subclavian injuries in blunt trauma are reported in less than 1% of all arterial injuries or chest related injuries. We report a female 68 yr-old patient whom has visited our emergency center due to a motorcycle traffic accident with complaints of right chest wall and shoulder pain. Her injury severity score was 22 and she was found with a comminuted clavicle fracture and subclavian artery injury. She developed delayed symptoms of pallor, pain and motor weakness with loss of pulse in her right arm. Attempts at intervention failed and thus, she underwent emergency artificial graft bypass from her subclavian artery to her brachial artery. Her postoperative course was uneventful and she is happy with the results. Although rare, a high index of suspicion for the injury must be noted and the inevitable surgical option must always be considered.
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