Disociación escapulo-torácica y trauma cerrado de arteria vertebral: reporte de un caso.

Abstract

Case Description: A 24-year-old male suffers from a motor vehicle accident with penetrating neck trauma and concomitant closed left cervicothoracic trauma. Clinical Findings: High impact trauma causing hypovolemic shock, left zone I penetrating neck trauma, ischemia due to blunt trauma to the axillary vessels, and brachial plexus injury. Transection of the vertebral artery on angiotomography. Diagnosed with scapulothoracic dissociation and vertebral artery trauma. Treatment and outcome: Axillary arteriovenous reconstruction, fasciotomies, non-surgical approach of the vertebral artery trauma, and deferred treatment of the brachial plexus trauma were performed. Survival of the patient and his limb, with major neurologic sequelae Clinical Relevance: The case presented here is an example of scapulothoracic dissociation with associated trauma to the vertebral artery, injuries that are uncommon and associated with high morbidity and mortality. Early recognition of the injuries and a multidisciplinary approach for this complex case by surgical board reviews at various levels within the course of care were key determinants in the patient’s improved prognosis. This case report presents an analysis of the diagnostics, treatment, and course; considering in-hospital care and the decision-making process as determinants for the prognosis in a polytrauma patient.

Scapulothoracic separation: A severe injury to the upper extremity

“…As per the latest findings put forth by certain experts, upon analyzing the measures taken to address this ailment, it has been observed that a significant number of individuals afflicted with this condition are likely to experience impairment of their vascular and neurological functions, with a bleak prognosis for most patients [ 2 , 4 , 5 , [7] , [8] , [9] , [10] , [11] , [12] , [13] , [14] , [15] ]. In instances of vascular damage, expeditious surgical intervention is frequently necessary to address the compromised blood vessels and safeguard both life and affected extremities.…”

Open reduction internal fixation with mesh plating and suture fixation for scapulothoracic dissociation: a case report and discussion of surgical methods

“…In the last decade, evidence in the literature has supported ORIF for cases of STD ( Table I ). 1 , 10 , 12 , 13 , 15 , 17 , 19 , 23 Lal et al reported the case of a 32-year-old male who sustained a Zelle 2B STD following a motor vehicle accident. They performed ORIF with successful recovery of a nearly full ROM in the shoulder postoperatively.…”