A 35 year old patient had a RTA and sustained injury to Right Elbow and Arm. He was primararily treated elsewhere and came to us after 8 hrs of injury.
But Radial Pulse was not palpable on the right side. Finger movements were full and SPO2 in the fingers showed 94% saturation.
CT Angio showed blockage of Brachial artery at the level of elbow with good distal flow in the ulnar and radial artery in the forearm.
- Surgery through Posterior approach
- Bony spike of proximal fragment touching the Brachial artery.
- Spike lifted and Torn Brachialis muscle repaired
- Artery found to be pulsating
- Fracture fixation done
- It is important to visualize the Brachial artery from Posterior approach
Post operative the distal SPO2 improved to 98% and Patient’s Limb Survived Without VASCULAR INTERVENTION.
X-rays
But Radial Pulse was not palpable on the right side. Finger movements were full and SPO2 in the fingers showed 94% saturation.
CT Angio showed blockage of Brachial artery at the level of elbow with good distal flow in the ulnar and radial artery in the forearm.
CT ANGIO
Operative Pearls :
- Bony spike of proximal fragment touching the Brachial artery.
- Spike lifted and Torn Brachialis muscle repaired
- Artery found to be pulsating
- Fracture fixation done
- It is important to visualize the Brachial artery from Posterior approach
INTRA OP PICTURES
POST OP XRAYS
Post operative the distal SPO2 improved to 98% and Patient’s Limb Survived Without VASCULAR INTERVENTION.
After 2 weeks of Surgery, PULSE was WELL PALPABLE and Patient had a full recovery.
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