The authors report 2 cases of acute axillary artery thrombosis in children with blunt trauma. The incidence and etiology of this injury are discussed, par ticularly as they relate to injury of the great vessels in blunt chest trauma. Diagnostic and therapeutic approaches are outlined for this uncommon but po tentially disabling condition.
Get full access to this article
View all access options for this article.
References
1.
Donovan DL, Sharp WV: Blunt trauma to the axillary artery. J Vasc Surg1:618-683, 1968.
2.
Natali J., Maraval M., Kieffer E., et al: Fractures of the clavicle and injuries of the subclavian artery . J Cardiovasc Surg16:541-547, 1975.
3.
Rich NM, Baugh JH, and Hughes CW: Acute arterial injuries in Vietnam: 1000 cases. J Trauma10:359-369, 1970.
4.
Graham JM, Mattox KL, Feliciano DV, et al: Vascular injuries of the axilla. Ann Surg195:232-238, 1982.
5.
Tse DH, Slabaugh PB, Carlson PA, et al: Injury to the axillary artery by a closed fracture of the clavicle. A case report. J Bone Joint Surg62:1372-1373, 1980.
6.
Weiner DS, O'Dell HW: Fractures of the first rib associated with injuries to the clavicle. J Trauma9:412-422, 1969.
7.
Phillips EH, Rogers WF, Gaspar MR: First rib fractures: Incidence of vascular injuries and indications for angiography . Surgery89:42-47, 1981.
8.
Gugenheim S. , Saunders RJ: Axillary artery injury caused by shoulder dislocation. Surgery95:55-58, 1984.
9.
Kirker JR: Dislocation of the shoulder complicated by rupture of the axillary vessels . J Bone Joint Surg34B:72-75, 1952.
10.
Zuckerman JD , Flugstad DL, Teitz CC, et al: Axillary artery injury as a complication of proximal humeral fractures. Two case reports and a review of the literature . Clin Orthop189:234-237, 1984.
11.
Thompson DA , Flynn TC, Miller PW, et al: The significance of scapular fractures . J Trauma25:974-977, 1985.
12.
Rockwood CA: Dislocations of the sternoclavicular joint. Instructional Course Lectures, The American Academy of Orthopedic Surgeons, St. Louis : CV Mosby, 24:144-159, 1975.
13.
Zelenock GB , Kazmers A., Graham LM, et al: Nonpenetrating subclavian artery injuries . Arch Surg120:685-692, 1985.
14.
Fischer RG, Hadlock F., and Ben-Menachan Y.: Laceration of the thoracic aorta by blunt trauma: Report of 54 cases and review of the literature. Radiol Clin N America19:91-101, 1981.
15.
Guilfoil PH , Christiansen T.: An unusual vascular complication of fractured clavicle. JAMA200:178-180, 1967.
16.
Ray RD, Sankaran B., Fetrow KO, et al: Delayed union and non-union in fractures. Instructional Course Lectures, The American Academy of Orthopedic Surgeons, St. Louis: CV Mosby, 18:255-270, 1973.
17.
Brewer LA: Surgical management of lesions of the thoracic duct. Am Surg90:210-227, 1955.
18.
Fabre H.: Contribution a l'etude des complications vasculaires des fractures de la clavicle . Thesis de Montpellier, 1894, No. 31.
19.
Dupuytren G. : Fracture de la clavicule en pleusiers fragments par cause indirecte. Gaz De Hospetaux4:819, 1831.
20.
Penn I.: Vascular complications of fractures of the clavicle. J Trauma4:819-831, 1964.
Steenburg JT , Ravitch MM: Cervicothoracic approach to subclavian vessel injury from compound fracture of the clavicle. Ann Surg157:839-845, 1963.
23.
Lodge FA, Lamberti JJ, Goodman AH, et al: Vascular consequences of subclavian artery transection for the treatment of congenital heart disease. J Thorac Cardiovasc Surg86:18-23, 1983.
24.
Cook FW, Haller JA: Penetrating injuries of the subclavian vessels with associated venous complications . Ann Surg155:370-372, 1962.
25.
Doty DB, Treiman RL, Rothschild PD, et al: Prevention of gangrene due to fractures. Surg Gynececol Obstet125:284-288, 1967.
26.
Rich NM, Metz CW, Hutton JE, et al: Internal versus external fixation of fractures with concomitant vascular injury in Vietnam. J Trauma11:463-473, 1971.
27.
Connoly, J. : Management of fractures associated with arterial injuries. Am J Surg120:331-338, 1970.
28.
Richardson D., Fallat M., Nagaraj H., et al: Arterial injuries in Children. Arch Surg116:685-689, 1981.
29.
Whitehouse WM, Coran AG, Stanley JC, et al: Pediatric vascular trauma. Arch Surg111:1269-1275, 1976.
