Postero-lateral elbow dislocation with traumatic brachial artery disruption.

Abstract

Dislocations of the elbow are the second most common large joint dislocation, following shoulder dislocations. Most are closed reductions, especially posterior or posterolateral types, and do not require surgical intervention. When an elbow dislocation involves a vascular structure-usually the brachial artery-this injury becomes a rare and life-threatening emergency. Collateral circulation can maintain distal pulses, so these injuries can be underdiagnosed. Without rapid intervention, complications of limb ischemia, compartment syndrome, nerve injury, and even amputation can occur. This report describes a case of a 38-year-old female with complete transection of the brachial artery after elbow dislocation, emphasizing the importance of a thorough vascular assessment in the trauma setting. This case illustrates that a routine elbow injury can be catastrophic when there is a vascular injury. Given that the distal pulses can be maintained, an arterial injury should not be excluded based on pulse alone. Rapid surgery and a multidisciplinary approach were able to address the vascular repair and reduce the joint. This case also exemplifies the multiple complications that can occur with such injuries, including anterior interosseous nerve palsy. This case provides an example of a rare injury and treatment, which may aid in future patient care in the field of underrecognized and high-risk elbow trauma.