Axillary artery and brachial plexus injury secondary to blunt trauma

Rupture of the axillary artery after blunt trauma is an unusual injury, typically occurring in association with anterior dislocation of the shoulder or fracture-dislocation of the surgical head of the humerus. An associated blunt brachial plexus injury will typically accompany such an injury due to its intimate anatomical juxtaposition. We present the case of an elderly female, who presented after a fall from height, onto the outstretched arm, sustaining a combined axillary artery and brachial plexus blunt injury. The patient in this case recovered well post-operatively. The challenge in cases such as this is timely diagnosis and management of the vascular injury. The mechanism of injury combined with the presence or absence of hard signs of vascular injury should alert the clinician with rapid transition to investigation and management where appropriate, to minimise the warm ischaemic time to the upper limb and / or control of haemorrhage. Blunt injuries to the brachial plexus often require a prolonged period of time before accurate recovery can be prognosticated for.