Abstract
Background
Fractures of the clavicle are extremely common, representing 2.6–12% of all fractures
and 35–44% of all shoulder girdle injuries; 69–82% of these fractures occur in the
middle third of the clavicle. Vascular injuries relating to clavicle fracture are
usually due to extreme force applied to the clavicle in an acute setting. No other
reports of delayed subclavian vein laceration were found on literature search.
Objectives
We present this case to increase awareness among emergency physicians of the potential
delayed presentation of this rare condition.
Case Report
A 21-year-old man presented to the Emergency Department with acute swelling of the
base of the neck after carrying a heavy load on his left shoulder the night before.
He had been recovering from a clavicle fracture for 2 months. Malunion of his left
midshaft clavicle fracture led to subclavian vein injury and formation of a large
hematoma secondary to reinjury that occurred at work the night before presentation.
Computed tomography revealed a 9-cm hematoma at the fracture site. The patient was
found to have a subclavian vein injury without evidence of arterial injury or nervous
system involvement. The patient was admitted for observation and subsequently discharged
without need for surgical intervention.
Conclusion
Subclavian vein laceration is a rare complication of clavicle fracture. Patient education
at discharge after conservative management is important due to the risk of vascular
complications from malunion and reinjury.
Keywords
To read this article in full you will need to make a payment
Purchase one-time access:
Academic & Personal: 24 hour online accessCorporate R&D Professionals: 24 hour online accessOne-time access price info
- For academic or personal research use, select 'Academic and Personal'
- For corporate R&D use, select 'Corporate R&D Professionals'
Subscribe:
Subscribe to Journal of Emergency MedicineAlready a print subscriber? Claim online access
Already an online subscriber? Sign in
Register: Create an account
Institutional Access: Sign in to ScienceDirect
References
- Epidemiology of clavicle fractures.J Shoulder Elbow Surg. 2002; 11: 452-456
- The incidence of fractures of the clavicle.Clin Orthop Relat Res. 1994; 300: 127-132
- Late complications following clavicular fractures and their operative management.Injury. 2003; 34: 69-74
- Subclavian artery and vein injury following clavicle fracture due to blunt trauma.Injury Extra. 2009; 40: 36-38
- Acute midshaft clavicle fracture.J Am Acad Orthop Surg. 2007; 15: 239-248
- Treatment of clavicular fractures: figure-of-eight versus a simple sling.Acta Orthop Scand. 1987; 58: 71-74
- The vascular complications of fracture of the clavicle.J Trauma. 1964; 4: 819-831
- Management of subclavian vascular injuries.J Trauma. 1980; 20: 537-544
Article info
Publication history
Published online: August 16, 2010
Accepted:
May 17,
2010
Received in revised form:
February 1,
2010
Received:
November 11,
2009
Identification
Copyright
© 2012 Elsevier Inc. Published by Elsevier Inc. All rights reserved.
