Pseudoaneurysm of the subclavian artery as a delayed complication of a clavicle fracture

BMJ Case Rep. 2023 May 2;16(5):e252430. doi: 10.1136/bcr-2022-252430.

Abstract

Vascular complications are relatively rare following surgical fixation of midshaft clavicle fractures. Here, we report a case of a woman in her 30s presenting 10 years after right clavicular open reduction and internal fixation with revision 6 years prior with sudden and rapidly progressive neck swelling. Physical examination revealed a soft pulsating mass in her right supraclavicular fossa. Ultrasound and CT angiography of the head and neck showed a pseudoaneurysm of her right subclavian artery with a surrounding haematoma. She was admitted to the vascular surgery team for endovascular repair with stenting. Postoperatively, she developed arterial thrombi requiring thrombectomy (twice) and is now on lifelong anticoagulation. It is crucial to be aware of complications that can develop in patients with a history of clavicular fracture managed non-operatively or operatively even years later and highlights the importance of risk and benefit discussions and counselling.

Keywords: Orthopaedic and trauma surgery; Orthopaedics; Radiology; Vascular surgery.

Publication types

  • Case Reports

MeSH terms

  • Aneurysm, False* / diagnostic imaging
  • Aneurysm, False* / etiology
  • Aneurysm, False* / surgery
  • Clavicle / diagnostic imaging
  • Clavicle / surgery
  • Female
  • Fracture Fixation, Internal / adverse effects
  • Fractures, Bone* / complications
  • Fractures, Bone* / diagnostic imaging
  • Fractures, Bone* / surgery
  • Humans
  • Subclavian Artery / diagnostic imaging
  • Subclavian Artery / surgery