抄録
Clavicle fracture is rarely associated with subclavicular artery injury but it most often develops soon after injury. I report a case of rupture of subclavian artery that developed one week after injury.
A-73-year-old woman had multiple fractures with left clavicle comminuted fracture in a traffic accident. Surgery for clavicle fracture was performed six days after injury. The day after the surgery, she felt pain in the left claviclular area after motion. Next day, numbness and swelling of her left upper limb appeared and she went into shock. She was transferred to another hospital with cardiovascular surgery. In CT, the left subclavian artery was crushed from the peripheral side just after thoracic cavity, and it became a pseudoaneurysm. According to the cardiovascular surgeon, the ruptured part was separate from the screw position, and damage was due to the fracture rather than by plate fixation. Coil embolization was performed. The circulation of the left arm is maintained.
Subclavian artery injury due to blunt injury is only 1% of the artery injury. Symptons of subclavian artery rupture are swelling, hypotension and numbness and pain of upper limb, but arterial injury cannot be excluded even if radial artery pulse does not disappear, because of collateral circulations.
This case that developed one week after injury is very rare. However, in clavicle fracture, when the fracture part is proximal, or when dislocation is large, there is a possibility of having produced subclavian artery injury at the time of injury, and it may appear subacutely.
