Subclavian artery occlusion after a clavicle fracture

Demir, Diba
van der Burg, Boudewijn Borger
Stollenwerck, Guido
Hoencamp, Rigo

¹ Department of Surgery, Alrijne Ziekenhuis Locatie Leiderdorp, Leiderdorp, The Netherlands
² Trauma Research Unit, Department of Surgery, ErasmusMC, University Medical Center Rotterdam, Rotterdam, The Netherlands
³ Department of Surgery, Leiden University Medical Centre, Leiden, The Netherlands
⁴ Defense Healthcare Department, Ministry of Defence, Utrecht, The Netherlands

Correspondence to Rigo Hoencamp, [email protected]

Accepted July 1, 2019.

Contributors All authors contributed to the idea to report the case. DD and RH did the literature search and drafted the manuscript. BBvdB, GS and RH, all provided critical feedback and revisions. All authors have provided final approval of the study protocol.

Funding The authors have not declared a specific grant for this research from any funding agency in the public, commercial or not-for-profit sectors.

Competing interests None declared.

Provenance and peer review Not commissioned; externally peer reviewed.

Patient consent for publication Obtained.

BMJ Case Reports 12(11):p e229314, November 2019. | DOI: 10.1136/bcr-2019-229314

SUMMARY

A 44-year-old man with a 9-day-old left displaced midshaft clavicle fracture was initially treated conservatively. The patient experienced an increase of pain with tickling and cold sensation in the left upper extremity. CT angiography showed left subclavian artery occlusion over 3 cm at the level of the fracture. At surgical repair, a subclavian-brachial bypass was constructed and fracture fixation was done with an eight-hole locking compression plate. Follow-up at 6 months showed full range of motion of the left shoulder, an open bypass and fracture consolidation.