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Revista Portuguesa de Ortopedia e Traumatologia

versão impressa ISSN 1646-2122

Resumo

PINHEIRO, Ana et al. Desenvolvimento de pseudoaneurisma após fratura da extremidade proximal do úmero. Rev. Port. Ortop. Traum. [online]. 2015, vol.23, n.3, pp.236-242. ISSN 1646-2122.

Proximal humerus fractures is the second most common fracture of the upper extremity and is included within the 3 most common fractures in patients over 65 years. Proximal humerus fractures with deviation may rarely be associated with vascular injuries that can be serious and go unnoticed, several facts contributing to this as its rarity, innocuous appearance of the x-ray at the entrance of the ER, difficulty in performing a clinical examination of the patient on admission for lack of collaboration, or even the benign appearance of some vascular lesions. However, their no identification can lead to disastrous consequences. The authors report a relevant case of vascular injury of the lateral thoracic artery associated with proximal humerus fracture with marked deviation, after low-energy trauma. The fracture was surgically corrected with kirschner wires (k wires) percutaneous fixation and evolved with the development of pseudoaneurysm. Patient presented unfavorable evolution after pseudoaneurysm surgical correction, with hospitalization in the Intensive Care Unit (ICU), progression to sepsis, multiorgan failure and death. This case warns the pseudoaneurysm could have originated by the initial trauma caused by the tops of the humeral bone fracture or as a complication of placing K wires for fracture reduction or by migration thereof during the postoperative period. The early identification of these complications and their appropriate treatment is crucial to prevent catastrophic results.

Palavras-chave : Proximal humerus fractures; pseudoaneurysm development; false aneurysm development; vascular injury; proximal humerus fractures complications; postoperative complications.

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