Late recurrent peripheral upper limb ischemia after non-union of a clavicle fracture

Clavicular non-union as an undiagnosed cause of progressive limb-threatening upper extremity ischemia

“…History of the fracture of the clavicle, even if remote, should draw attention to the possible arterial compression syndrome. The arterial compression by the pseudoarthrosis of the clavicle is a rare but already described cause [2,3]. Interestingly, there was a 50-year interval between clavicular fracture and the occurrence of limb threatening ischemia.…”

Recurrent acute limb ischaemia and thoracic outlet syndrome secondary to a clavicle fracture malunion

“…8 Arterial involvement is rare being <1% of all forms of thoracic outlet syndrome and the diagnosis is confirmed by targeted imaging of the vessels. 7,8 We present a case of ATOS and recurrent acute arterial limb ischaemia secondary to subclavian artery impingement related to a clavicle malunion. This case is the first to report that intraoperative findings suggest the impingement is secondary to soft tissue adhesions rather than bony callus compression or pseudoaneurysm.…”

“…Vascular complications after clavicle fractures are rare but have been described in the literature. Most of the cases described are because of a pseudoaneurysm formation due to vascular compression secondary to a hypertrophic bony callus formation associated with non‐union 7. They typically present with vascular compromise or symptoms of thoracic outlet syndrome 8.…”

“…They typically present with vascular compromise or symptoms of thoracic outlet syndrome 8. Arterial involvement is rare being <1% of all forms of thoracic outlet syndrome and the diagnosis is confirmed by targeted imaging of the vessels 8…”

“…Most of the cases described are because of a pseudoaneurysm formation due to vascular compression secondary to a hypertrophic bony callus formation associated with non-union. 7 They typically present with vascular compromise…”