Compression of the brachial plexus in a patient with false aneurysm of the axillary artery as a result of anterior shoulder dislocation

Abstract

The shoulder is the most commonly dislocated major joint in the body. 9 Rockwood Jr, CA Green DP 4th ed. Fractures in adults. Volume 2. Lippincott-Raven, Philadelphia1996 Google Scholar Anterior dislocation of the shoulder is a common presentation to emergency departments, with an incidence that can range from 0.017% to 1.7%. 5 Hovelius L. Incidence of shoulder dislocation in Sweden. Clin Orthop. 1982; 166: 127-131 PubMed Google Scholar , 6 Kroner K Lind T Jensen J. The epidemiology of shoulder dislocations. Arch Orthop Trauma Surg. 1989; 108: 288-290 Crossref PubMed Scopus (207) Google Scholar Neuropraxia from direct brachial plexus injuries is not uncommon and usually carries a good prognosis. 10 Toolanen G Hildingsson C Hedlund T Knibestol M Oberg L. Early complications after anterior dislocation of the shoulder in patients over 40 years. An ultrasonographic and electromyographic study. Acta Orthop Scand. 1993; 64: 549-552 Crossref PubMed Scopus (90) Google Scholar Vascular complications from such an injury are rare, and reports of their occurrence in the literature are sporadic. Gates et al 4 Gates JD Knox JB Axillary artery injuries secondary to anterior dislocation of the shoulder. J Trauma. 1995; 39: 581-583 Crossref PubMed Scopus (58) Google Scholar reviewed the English literature between 1956 and 1995 and found only 22 cases of anterior dislocation with axillary artery injury. We have reviewed the English literature from 1995 to date and have found 2 further cases. 2 Emadian SM Lee WW Axillary artery pseudoaneurysm and axillary nerve palsy: delayed sequelae of anterior shoulder dislocation. Am J Emerg Med. 1996; 14: 108-109 Abstract Full Text PDF PubMed Scopus (19) Google Scholar , 7 Mullett H Babu J McMahon B Burke P. Vascular complication of anterior dislocation of shoulder with associated brachial plexus injury: a case report. Ir J Med Sci. 1998; 167: 196 Crossref PubMed Scopus (7) Google Scholar We report a case of anterior dislocation of the left shoulder that gave rise to a false aneurysm of the axillary artery and subsequent compression and axonotmesis of the brachial plexus.