A 55-year-old man fell down while inebriated and sustained a right clavicular fracture. He complained of paresthesia, paleness, coldness and parlalysis of his right arm. An expanding subcutaneous hematoma in the supraclavicular region was noted as well as radial artery pulsation at the right wrist.
A rupture of the Subclavian artery was diagnosed without an angiogram and the middle part of the clavicle arteriogrhaphy was performed. Pulse deficit distal to the injury is one sign of Subclavian artery injury. However this is not altogether reliable because of good collateral circulation about the shoulder. There is no clear consensus as to which approach to the subclavian artery would give the best exposure and in particular control the proximal segment. For succesful management, proper surgical exposure and revascularization techniques are essential.
