A rare presentation of mid shaft humerus fracture with axillary artery & brachial artery traumatic thrombus with brachial plexus palsy

Abstract

Humerus fractures account for 3% of all orthopaedic injuries and are common among adult population following trauma. With high velocity trauma we witness associated injury to nearby vessels, nerves or both. We present a rare case of mid shaft humerus fracture associated with brachial artery, axillary artery and brachial plexus injury, sustained at work place while operating the heavy hydraulic door of a lorry. Emergency CT-angio was done and site of vascular injury was identified, following which patient was taken up for surgery. Fracture was first fixed by open reduction and internal fixation (ORIF) through anterolateral approach with locking plate and it was followed by vascular reverse saphenous vein bypass graft from axillary artery to distal brachial artery through a median approach.