Pseudoaneurysm of axillary artery secondary to proximal humeral fracture: clinical features

Abstract

We present here a case wherein the patient developed an unsuspected pseudoaneurysm (also called a false aneurysm) secondary to a low-energy proximal humeral fracture. Massive hemorrhaging from the pseudoaneurysm occurred around 4 months from the initial injury. Neurovascular deficit and necrosis were present upon examination and the limb was unsalvageable. The delay in treatment resulted in a severe and irreversible neurovascular deficit. A shoulder disarticulation was performed and postoperative progress was favorable. Early diagnosis and surgical intervention is critical to recovery in such cases. Common features and challenges associated with this sort of injury are here described based on a review of past case reports and on our own case. Although early diagnosis is difficult, the following are some clinical features of a pseudoaneurysm secondary to a proximal humeral fracture (1) delayed presentation; (2) severe anteromedial displacement of the fracture; (3) somewhat atypical symptoms such as a recurrence or persistence of shoulder swelling and pain.