Axillary artery laceration after an anterior shoulder dislocation presenting as hypovolemic shock

Axillary Artery Transection and Brachial Plexus Injury After Open Inferior Glenohumeral Dislocation: A Case Report

CASE

A judo athlete presented with an open inferior shoulder dislocation that occurred during competition. Examination revealed a transection of the axillary artery and neuropraxia of the posterior cord. Neuropraxia was resolved within 2 weeks. The axillary artery was repaired with a femoral vein graft. He regained full strength, range of motion, and function at 8 months.

CONCLUSION

Inferior glenohumeral dislocations are rare, and their management can be complicated by vascular and neurological injuries. We emphasize the importance of examination, diagnosis, and treatment of neurovascular pathologies to avoid catastrophic outcomes.

Fatal Outcome After Reduction of a Superior Shoulder Dislocation, A Case Report and Literature Review: A Case Report and Literature Review

CASE

An 81-year-old woman presented a superior glenohumeral dislocation after a low-energy fall, with a mechanism of axial load while the shoulder was in adduction and extension. After successful closed reduction, the patient presented sudden symptoms of severe vascular injury with a protruding axillary hematoma and hypovolemic shock.

CONCLUSION

Superior shoulder dislocations and vascular injuries are extremely rare among shoulder dislocations, especially after low-energy trauma. Vascular injuries may result in limb compromise and death. We highlight the importance of high clinical suspicion, particularly in superior dislocations, and the importance of prompt management of vascular complications to avoid catastrophic outcomes.

Axillary artery laceration after anterior shoulder dislocation reduction

Introduction

Glenohumeral dislocation is the most commonly encountered dislocation in the emergency department. The most frequent complications of glenohumeral dislocation are rotator cuff tears and an increase in the risk of recurrent dislocation. Less common acute complications include fractures, neurological complications and vascular injuries. The incidence of axillary artery injury associated with shoulder dislocation is reported to be about 1–2%.

Case

An 81-year-old male presented to the emergency department with pain in the right shoulder after a fall. On physical examination, the shoulder was in slight abduction and external rotation. Shoulder movements were painful and there was a swelling in the axillary region which was tender to palpation. There was no sensory or motor deficit and the peripheral pulses were equal and palpable. Following the administration of analgesics, shoulder reduction was performed using the flexion-adduction-external rotation method. After reduction, the patient started complaining of axillary pain. On control examination, the patient did not have any motor or sensory deficits, but peripheral pulses were not palpable on the right arm. The right upper extremity computed tomography angiography, which was performed with the suspicion of vascular injury, revealed a right axillary artery rupture.

Conclusion

Axillary artery injury accompanying anterior shoulder dislocation is a rare but serious condition which may result in limb loss and death.