Int J Angiol 2015; 24(04): 296-299
DOI: 10.1055/s-0034-1372246
Case Report
Thieme Medical Publishers 333 Seventh Avenue, New York, NY 10001, USA.

Axillary Artery Injury Accompanying Humeral Neck Fracture

Shamir O. Cawich
1   Department of Clinical Surgical Sciences, University of the West Indies, St. Augustine, Trinidad and Tobago
,
Patrick Harnarayan
1   Department of Clinical Surgical Sciences, University of the West Indies, St. Augustine, Trinidad and Tobago
,
Steve Budhooram
1   Department of Clinical Surgical Sciences, University of the West Indies, St. Augustine, Trinidad and Tobago
,
Vijay Naraynsingh
1   Department of Clinical Surgical Sciences, University of the West Indies, St. Augustine, Trinidad and Tobago
› Author Affiliations
Further Information

Publication History

Publication Date:
12 May 2014 (online)

Abstract

Injuries to the axillary artery from proximal humeral fractures are uncommon. There are only 66 such injuries reported across the world literature to date. We report an additional case of axillary artery injury. This case highlights the importance of maintaining a high index of suspicion to prevent diagnostic delay.

 
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