Download - Double brachial artery dr. kk
TITLE: Vascular injury with fracture
humerus encountered in a case of double
axillary artery and double brachial artery
- A rare clinical case report.
AUTHOURS: Dr. Sanjeev Jain
Dr. K. Kalaivanan *
Dr. Aditya C Pathak
Dr. Amish P Mhatre
INTRODUCTION
• To the best of our knowledge, such a rare combination of double axillary and double brachial arteries encountered in a case of fracture humerus with brachial artery injury is the first to report in clinical practice.
• A 30-year-old female presented to our accident and emergency department with fracture right humerus and absent right radial pulse.
CASE STUDY
• Her contrast-enhanced computed tomographicangiography revealed high bifurcation of right subclavian artery prior to axilla into two axillaryarteries.
• The axillary artery-1 continued as the superficial brachioulnar artery.
• The axillary artery-2 continued as the deep brachioradial artery with an occlusion in its flow at the level of fracture right humerus.
• Distal to the occlusion, the deep brachioradial artery continued to form intact palmar arch with superficial brachioulnar artery.
CASE STUDY
• The fracture humerus was fixed with plate osteosynthesis and bone grafting.
• Non-invasive treatment method was chosen for brachial artery injury, intraoperatively.
• With a complete clinico-radiological investigation and better preoperative planning, we protected her superficial brachioulnar artery from iatrogenic injury.
CONCLUSION
The key message of our study is that
“every trauma case needs a thorough
clinical examination and an adequate
radiological examination with proper
preoperative planning to avoid iatrogenic
injury”.
This rare branching pattern is named as
“Jain Variation” for literature support.
CT ANGIOGRAPH
Axillary artery-2
continued as the
deep brachioradial
artery with an
occlusion in its flow
at the level of
fracture.
FRACTURE PATTERN
• A - X-RAY AP VIEW
# HUMERUS.
• B - X-RAY LATERAL
VIEW # HUMERUS.
• C - X-RAY AP VIEW
HUMERUS PLATING.
• D - X-RAY LATERAL
VIEW HUMERUS
PLATING.
REFRENCES
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