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BMJ Case Reports 2016; doi:10.1136/bcr-2016-216336
  • CASE REPORT

Arterial damages in acute elbow dislocations: which diagnostic tests are required?

Editor's Choice
  1. Volker Schoeffl2
  1. 1CVPath Institute, Gaithersburg, Maryland, USA
  2. 2Department of Sports Orthopedics, Sports Medicine, Sports Traumatology, Department for Orthopedics and Traumatology, Klinikum Bamberg, Bamberg, Germany
  1. Correspondence to Dr Christoph Lutter, christoph.lutter{at}googlemail.com
  • Accepted 5 July 2016
  • Published 19 July 2016

Summary

Blunt vessel injuries of peripheral arteries caused by a direct trauma are rare. Studies have described the frequency of arterial ruptures following closed elbow dislocations in 0.3–1.7% of all cases. However, arterial damage does not always necessarily appear as a complete rupture of the vessel with a loss of peripheral circulation and ischaemic symptoms; a relatively strong periarticular system of collaterals can maintain circulation. Furthermore, the traumatic dislocation can also cause intimal tears, arterial dissections and aneurysms or thrombosis. In all cases of vessel injury, including total disruption, a peripheral pulse might still be palpable. 3 weeks after an acute elbow dislocation, we have diagnosed a patient with a long-segment stenosis of the brachial artery and a thrombosis of the radial artery. Therefore, the close anatomic proximity to the neurovascular structures should always be considered in cases of elbow dislocations, even if peripheral pulses are traceable.

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