Subclavian artery pseudoaneurysm due to clavicle fixation sc
Vascular injuries are an extremely rare complication of clavicle osteosynthesis. This case underscores the importance of selecting appropriate screws based on available imaging.

A 27-year-old female underwent operative plate and screw fixation of a left mid-clavicle fracture sustained in a mountain biking accident. The fracture went on to nonunion. Therefore, revision with iliac crest bone graft was performed. About 2 weeks after the revision, the patient began to develop swelling and pain along the superior side of the clavicle, as well as numbness and tingling in the left arm in an ulnar nerve distribution. A palpable mass with an arterial pulse was appreciated near the clavicle. A bruit was auscultated with a stethoscope. Neurovascular exam of the distal extremity was normal.

CT angiography of the chest demonstrated a distal left subclavian artery pseudoaneurysm measuring 5 × 8 × 8 mm, with an immediately adjacent orthopedic screw. A same-day radiograph revealed persistent nonunion of the original clavicle fracture. The pseudoaneurysm was addressed by retrograde endovascular cannulation and coil embolization.

Source: Journal of radiology case reports

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