Background: We experienced 2 cases of axillary artery injuries complicating proximal humeral fracture. Preoperative CT images were evaluated retrospectively in patients with proximal humeral fractures who underwent surgery in our hospital. The purpose of this study is to evaluate the association between the medial displacement of the humeral shaft and axillary artery injuries.
Methods: A total of 27 patients with proximal humeral fractures who underwent open reduction and internal fixation between April 2010 and March 2012 were included in this study. There were 11 men and 16 women with a mean age of 63.0 years (24 to 92 years). We retrospectively evaluated preoperative CT images, and the distance between the medially displaced humeral shaft and the axillary artery was assessed.
Results: Axillary artery injury was observed in 2 patients. The distance between the medially displaced shaft and the axillary artery showed a significant difference between the group with axillary artery injury (injury group: Group I) and the group without axillary artery injury (non-injury group: Group NI).
Discussion: We consider that there is a risk of axillary artery injuries at the time of injury or reduction when patients have remarkable medial displacement of the shaft in a proximal humeral fracture, regardless of the AO classification, and therefore require adequate attention. We suggest that patients with remarkable medial displacement of the shaft in a proximal humeral fracture undergo preoperative CT angiography or doppler ultrasound to evaluate the risk of axillary artery injury.
