Critical ischemia and myonecrotic sepsis following scapulothoracic dissociation in the setting of apparent hand perfusion: A case report.
flail extremity
ischemia
scapulothoracic dissociation
subclavian artery
upper-extremity
Journal
OTA international : the open access journal of orthopaedic trauma
ISSN: 2574-2167
Titre abrégé: OTA Int
Pays: United States
ID NLM: 101770383
Informations de publication
Date de publication:
Dec 2019
Dec 2019
Historique:
received:
10
07
2019
accepted:
16
10
2019
entrez:
3
5
2021
pubmed:
13
12
2019
medline:
13
12
2019
Statut:
epublish
Résumé
Scapulothoracic dissociation is a rare and devastating injury to the shoulder girdle. It is often caused by traction or severe blunt trauma injury to the upper extremity and is associated with both neurologic and vascular injuries. Scapulothoracic dissociation is a highly morbid and rare injury pattern that is often seen in conjunction with other traumatic injuries. The authors describe a case of scapulothoracic dissociation with associated complete brachial plexus injury and subclavian artery injury that was complicated by hypoperfusion, myonecrosis, and subsequent polymicrobial infection of the affected limb in the setting of a warm hand with brisk capillary refill. While capillary refill and hand warmth in the setting of a pulseless extremity have been used in previous cases of scapulothoracic dissociation as an indication for limb perfusion and nonoperative management, these markers cannot reliably be used to evaluate collateral circulation as exemplified in this case report. This case highlights multiple important aspects of the evaluation and management of scapulothoracic dissociation that orthopaedic surgeons and vascular surgeons should be familiar with and utilize when dealing with these challenging injuries.
Identifiants
pubmed: 33937676
doi: 10.1097/OI9.0000000000000048
pii: OTAI-D-19-00033
pmc: PMC7997118
doi:
Types de publication
Case Reports
Langues
eng
Pagination
e048Informations de copyright
Copyright © 2019 The Authors. Published by Wolters Kluwer Health, Inc. on behalf of the Orthopaedic Trauma Association.
Déclaration de conflit d'intérêts
The authors have no conflicts of interest to disclose.
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