Axillary artery and brachial plexus injury after anterior shoulder dislocation: report of a case and review of the literature

The shoulder is the most commonly dislocated major joint of the body, but associated injury to the axillary artery and the brachial plexus has only been reported sporadically in the literature. This review presents the case of an elderly man with a recurrent dislocation, transection of the axillary artery and an associated severe brachial plexus injury. It also presents the pathognomonic triad of anterior shoulder dislocation, absent peripheral pulse and expanding axillary haematoma to raise the index of suspicion for identifying this limb-threatening injury, which demands immediate arteriography and surgical exploration. This kind of rare injury can be easily missed without a simple clinical examination.