Acute-on-Chronic Axillary Artery Thrombus After Reverse Total Shoulder Arthroplasty for Failed Proximal Humerus Open Reduction and Internal Fixation: A Case Report

JBJS Case Connect. 2024 May 10;14(2). doi: 10.2106/JBJS.CC.23.00681. eCollection 2024 Apr 1.

Abstract

Case: A 71-year-old woman presented with post-traumatic arthritis 11 months after open reduction and internal fixation for a left proximal humerus fracture (PHF) dislocation. After revision to reverse total shoulder arthroplasty (rTSA), the patient's left upper extremity was found to be avascular. An emergent thrombectomy was performed with restoration of arterial flow after removal of an acute-on-chronic axillary artery thrombus.

Conclusion: Although rare, as rTSA becomes more common for management of PHF, incidence of associated vascular injuries is likely to rise. Screening methods and clinical vigilance in diagnosis are advised for patients with anterior PHF dislocations and arterial injury risk factors.

Publication types

  • Case Reports

MeSH terms

  • Aged
  • Arthroplasty, Replacement, Shoulder* / adverse effects
  • Axillary Artery* / diagnostic imaging
  • Axillary Artery* / injuries
  • Axillary Artery* / surgery
  • Female
  • Fracture Fixation, Internal / adverse effects
  • Humans
  • Open Fracture Reduction / adverse effects
  • Postoperative Complications / diagnostic imaging
  • Postoperative Complications / etiology
  • Reoperation
  • Shoulder Fractures* / diagnostic imaging
  • Shoulder Fractures* / surgery
  • Thrombosis* / diagnostic imaging
  • Thrombosis* / etiology
  • Thrombosis* / surgery