The Flail and Pulseless Upper Limb: an Extreme Case of Traumatic Scapulo-thoracic Dissociation
- Author:
Maria SW
;
Sapuan J
;
Abdullah S
- Publication Type:Case Reports
- Keywords:
Scapulo-thoracic dissociation;
complete brachial plexus injury;
subclavian artery injury
- MeSH:
Fractures, Bone
- From:Malaysian Orthopaedic Journal
2015;9(2):54-56
- CountryMalaysia
- Language:English
-
Abstract:
Scapulo-thoracic dissociation is an infrequent injury
resulting from high energy trauma which is often associated
with severe neurological and vascular injuries which may be
unrecognised at the time of presentation. A 24 year-old
female presented with bilateral rib fractures, pneumothorax,
liver and kidney injuries following a road traffic accident.
She also sustained fractures of her right scapula, odontoid,
right transverse processes of the thoracic and lumbar
vertebrae and a closed fracture of her right femur. Her right
upper limb was later noted to be flail and pulseless, due to
complete right brachial plexus injury, scapula-thoracic
dissociation and subclavian artery avulsion. We managed
the upper limb injuries non-operatively, and focused on
resuscitation of the patient. Early exploration of the complete
brachial plexus injury was not undertaken in spite of the
possible associated poor functional outcome as there was no
life-threatening indication.
- Full text:P020151027579459407798.pdf
