Axillary Artery Injuries Associated With Proximal Humerus Fractures: A Literature Review and a Proposal of a Novel Multidisciplinary Surgical Approach

Author:

Ripoll Thomas12ORCID,Fairag Rayan3,Bonomo Iris4ORCID,Gastaud Olivier2,Psacharopulo Daniele1

Affiliation:

1. Service de Chirurgie Vasculaire, Centre Hospitalier de Cannes, Cannes, France

2. Service de Chirurgie Orthopédique, Centre Hospitalier de Cannes, Cannes, France

3. Service de Chirurgie Orthopédique, Centre Hospitalier Universitaire de Nice, Nice, France

4. Service de Gynécologie, Institut Bergonié, Bordeaux, France

Abstract

Introduction Proximal humerus fractures (PHF) are common injuries that can lead to axillary artery injury, which carries the risk of not being identified during initial assessment. The aim of this study was to describe the management of suspected axillary artery injury associated with PHF according to our experience and to describe a new multidisciplinary surgical approach. Methods This was a single-center retrospective study. A database was created for patients admitted for PHF to the emergency department of the Hospital of Cannes between October 2017 and October 2019. Patients admitted with PHF associated with suspected ipsilateral upper limb ischemia, and/or massive diaphysis displacement, and/or upper limb ipsilateral neurological deficits were included in this study. Results In total, 301 patients diagnosed with PHF were admitted within these periods. Among these patients, 12 presented with suspected axillary artery lesions, of whom, 6 were included in the present study and treated according to our new approach. A description of these 6 cases, along with an extensive literature review is presented. Conclusion Based on our experience, the endovascular approach proposed for the management of axillary artery injury associated with proximal humerus fractures is effective, feasible and reproducible.

Publisher

SAGE Publications

Subject

Cardiology and Cardiovascular Medicine,General Medicine,Surgery

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