Eur J Cardiothorac Surg 2006;30:671
© 2006 Elsevier Science NL
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Scapulothoracic dissociation with subclavian artery dissection following a severe motorbike accident
Karsten Knoblocha,*,
Christian von Falckb,
Omke Teebkenc,
Christian Kretteka
a Trauma Department, Hannover Medical School, Carl-Neuberg-Str. 1, 30625 Hannover, Germany
b Department of Radiology, Hannover Medical School, Hannover, Germany
c Department of Cardiothoracic and Vascular Surgery, Hannover Medical School, Hannover, Germany
Received 30 May 2006;
received in revised form 12 July 2006;
accepted 13 July 2006.
* Corresponding author. Tel.: +49 511 532 2052; fax: +49 511 532 5877. (Email: kknobi{at}yahoo.com).
Key Words: Trauma • Dissection • Injury • Subclavian artery • Computer tomography
A 52-year-old motorbike driver was struck by a trailer. His left shoulder was swollen and no pulse was evident at his left wrist. In the emergency room, a scapulothoracic dissociation with subclavian artery dissection and a complex fracture of the humerus were evident (Fig. 1
). Carotido-subclavian bypass restored blood flow with preservation of the arm in follow-up (Fig. 2
).
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Fig. 1. 3D-computer tomography with reformation demonstrating the sternoclavicular dislocation at the left side with dissection of the subclavian artery 2 cm distal to the vertebral artery, fracture of the scapula at the inferior margin, and refill of the subclavian artery due to collaterals.
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Fig. 2. 3D-computer tomography six days following surgery after stabilization of the pulmonary function of the patient due to severe concomitant lung contusion demonstrating a left carotido-subclavian bypass using a saphenous vein graft for re-establishing of the left arm blood flow.
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