Occult thoracoacromial artery injury during reverse total shoulder arthroplasty resulting in a cascade of postoperative complications: A case report
We report a case of a 78-year old female patient got the reverse total shoulder arthroplasty with a series of events. After diagnosed with anterior shoulder dislocation and coracoid process fracture at a local hospital, she received conservative care after reduction but persistent reduction loss occ...
| Main Authors: | , , |
|---|---|
| Format: | Article |
| Language: | English |
| Published: |
Elsevier
2020-09-01
|
| Series: | Radiology Case Reports |
| Subjects: | |
| Online Access: | http://www.sciencedirect.com/science/article/pii/S1930043320303101 |
| _version_ | 1828498240682590208 |
|---|---|
| author | Young Min Noh, MD Hyun Su Do, MD Si Young Heo, MD |
| author_facet | Young Min Noh, MD Hyun Su Do, MD Si Young Heo, MD |
| author_sort | Young Min Noh, MD |
| collection | DOAJ |
| description | We report a case of a 78-year old female patient got the reverse total shoulder arthroplasty with a series of events. After diagnosed with anterior shoulder dislocation and coracoid process fracture at a local hospital, she received conservative care after reduction but persistent reduction loss occurred. Preoperative Magnetic Resonance Imaging confirmed underlying massive fatty infiltration and severe retraction of rotator cuff muscles. Considering underlying chronic rotator cuff arthropathy on preoperative X-ray and Computed Tomography scan with irreparable rotator cuff tears, we decided to perform reverse total shoulder arthroplasty. After unexpected vessel injury possibly due to underlying bleeding tendency or intra-operative procedure, severe complications occurred including active arterial bleeding, brachial plexus palsy and skin necrosis. Serial managements which included embolization of the artery, wound management while implant exposure status, and operative coverage of a skin defect by Latissimus Dorsi pedicled flap and Split Thickness Skin Graft were done. This series of events suggests that surgeons should be more careful than we were about possible injuries of small vessel branches that can cause unexpected complications, and keep in mind the importance of immediate cooperation with other medical professionals such as radiologists, plastic surgeons, and thoracic surgeons. |
| first_indexed | 2024-12-11T13:03:28Z |
| format | Article |
| id | doaj.art-33bc4785ab0e4fc887e39a14a5b6e457 |
| institution | Directory Open Access Journal |
| issn | 1930-0433 |
| language | English |
| last_indexed | 2024-12-11T13:03:28Z |
| publishDate | 2020-09-01 |
| publisher | Elsevier |
| record_format | Article |
| series | Radiology Case Reports |
| spelling | doaj.art-33bc4785ab0e4fc887e39a14a5b6e4572022-12-22T01:06:24ZengElsevierRadiology Case Reports1930-04332020-09-0115916571662Occult thoracoacromial artery injury during reverse total shoulder arthroplasty resulting in a cascade of postoperative complications: A case reportYoung Min Noh, MD0Hyun Su Do, MD1Si Young Heo, MD2Corresponding author. E-mail address: (Y. Min Noh); Department of Orthopedic Surgery, College of Medicine, Dong-A University, Busan, KoreaDepartment of Orthopedic Surgery, College of Medicine, Dong-A University, Busan, KoreaDepartment of Orthopedic Surgery, College of Medicine, Dong-A University, Busan, KoreaWe report a case of a 78-year old female patient got the reverse total shoulder arthroplasty with a series of events. After diagnosed with anterior shoulder dislocation and coracoid process fracture at a local hospital, she received conservative care after reduction but persistent reduction loss occurred. Preoperative Magnetic Resonance Imaging confirmed underlying massive fatty infiltration and severe retraction of rotator cuff muscles. Considering underlying chronic rotator cuff arthropathy on preoperative X-ray and Computed Tomography scan with irreparable rotator cuff tears, we decided to perform reverse total shoulder arthroplasty. After unexpected vessel injury possibly due to underlying bleeding tendency or intra-operative procedure, severe complications occurred including active arterial bleeding, brachial plexus palsy and skin necrosis. Serial managements which included embolization of the artery, wound management while implant exposure status, and operative coverage of a skin defect by Latissimus Dorsi pedicled flap and Split Thickness Skin Graft were done. This series of events suggests that surgeons should be more careful than we were about possible injuries of small vessel branches that can cause unexpected complications, and keep in mind the importance of immediate cooperation with other medical professionals such as radiologists, plastic surgeons, and thoracic surgeons.http://www.sciencedirect.com/science/article/pii/S1930043320303101Reverse total shoulder arthroplastyMorel-lavallée lesionLatissimus dorsi muscle flapDebridementComplicationVessel injury |
| spellingShingle | Young Min Noh, MD Hyun Su Do, MD Si Young Heo, MD Occult thoracoacromial artery injury during reverse total shoulder arthroplasty resulting in a cascade of postoperative complications: A case report Radiology Case Reports Reverse total shoulder arthroplasty Morel-lavallée lesion Latissimus dorsi muscle flap Debridement Complication Vessel injury |
| title | Occult thoracoacromial artery injury during reverse total shoulder arthroplasty resulting in a cascade of postoperative complications: A case report |
| title_full | Occult thoracoacromial artery injury during reverse total shoulder arthroplasty resulting in a cascade of postoperative complications: A case report |
| title_fullStr | Occult thoracoacromial artery injury during reverse total shoulder arthroplasty resulting in a cascade of postoperative complications: A case report |
| title_full_unstemmed | Occult thoracoacromial artery injury during reverse total shoulder arthroplasty resulting in a cascade of postoperative complications: A case report |
| title_short | Occult thoracoacromial artery injury during reverse total shoulder arthroplasty resulting in a cascade of postoperative complications: A case report |
| title_sort | occult thoracoacromial artery injury during reverse total shoulder arthroplasty resulting in a cascade of postoperative complications a case report |
| topic | Reverse total shoulder arthroplasty Morel-lavallée lesion Latissimus dorsi muscle flap Debridement Complication Vessel injury |
| url | http://www.sciencedirect.com/science/article/pii/S1930043320303101 |
| work_keys_str_mv | AT youngminnohmd occultthoracoacromialarteryinjuryduringreversetotalshoulderarthroplastyresultinginacascadeofpostoperativecomplicationsacasereport AT hyunsudomd occultthoracoacromialarteryinjuryduringreversetotalshoulderarthroplastyresultinginacascadeofpostoperativecomplicationsacasereport AT siyoungheomd occultthoracoacromialarteryinjuryduringreversetotalshoulderarthroplastyresultinginacascadeofpostoperativecomplicationsacasereport |