Axillary vein thrombosis and compartment syndrome in upper limb trauma

Abstract

Axillary thrombophlebitis and compartment syndrome are potential complications of upper limb trauma with significant morbidity and mortality. A 25 year old man presented 24 hours following an isolated limb injury with these synchronous complications. Early systemic anticoagulation and fasciotomy resulted in significant bleeding and anaemia. Renal function remained normal despite evidence of significant rhabdomyolysis (CK>16 000U/L). Several attempts at closure of fasciotomies were frustrated by major swelling and finally, devitalised biceps brachii was debrided in toto. He was discharged with residual sensory and motor deficits. Three months later, he had marked disability from weakness, sensory disturbance and post-phlebitic swelling.