Injury to the axillary artery and brachial plexus caused by a closed floating shoulder injury: A case report

Figure 1 Closed left “floating shoulder”. Marked soft tissue swelling, subcutaneous congestion, and deformity of the left shoulder were observed.

Figure 2 Plain anterior-posterior radiograph and computed tomography image of the left shoulder. A: X-ray demonstrating fractures of the left scapula, left proximal humerus, left clavicle and left shoulder soft tissue swelling; B: 3D computed tomography angiography reconstruction of the left shoulder also demonstrating multiple fractures of the scapular region and interruption of blood flow through the axillary artery.

Figure 3 Doppler ultrasound revealed interruption of blood flow through the axillary artery. A: The distal axillay artery was not unclear; B: The perivascular blood accumulation was obvious.

Figure 4 The axillary artery injury and repair. A: Emergency surgery revealed that the axillary artery was completely amputated; B: End-to-end anastomoses were thus performed after excision of traumatized vessel segments.

Figure 5 Evidence that axillary artery injury was successfully repaired. A: Computed tomography (CT) angiography confirmed that blood flow of the left axillary artery was restored after vascular repair; B: CT angiography without bone confirmed that blood flow of the left axillary artery was restored after vascular repair.

Figure 6 Postoperative radiographs showing reduction and locking plate. A: Positive slice; B: Oblique slice.