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Clavicular fracture and upper-extremity deep venous thrombosis.

机译:锁骨骨折和上肢深静脉血栓形成。

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Upper-extremity deep venous thrombosis (DVT) is considered an uncommon clinical event with considerable potential for morbidity. This article presents a case of upper-extremity DVT following a clavicular fracture. A 25-year-old man presented with pain and distortion of the left midclavicular area after falling on his left shoulder during martial arts practice. Following physical examination and radiography, he was diagnosed with a simple displaced clavicle fracture at the middle third. The patient had no previous surgery or medical problem, and did not smoke. No family history of blood clotting disorders were present and neurovascular examination appeared normal on the symmetric contralateral side. A figure-of-8 bandage was applied to support the arm and the patient was discharged. One week later, he returned with swelling and severe pain in his left arm. On examination, a DVT was suspected and the figure-of-8 brace was removed. A Doppler ultrasonography was performed and the presence of a thrombus extending from the brachial axillary veins to the distal subclavian vein with no flow in that segment was revealed. The patient was placed in a sling instead of a figure-of-8 bandage to immobilize the arm, while anticoagulation therapy with enoxaparin was started (1 mg/kg every 12 hours, 80 mg subcutaneous daily for 3 months). The swelling was reduced after 5 days. At 2-week follow-up, the patient had no pain and the swelling had completely disappeared.
机译:上肢深静脉血栓形成(DVT)被认为是一种罕见的临床事件,具有相当大的发病可能性。本文介绍了锁骨骨折后上肢DVT的情况。一名25岁的男子在武术练习中跌落到左肩后出现左锁骨中部区域的疼痛和扭曲。经过体格检查和射线照相后,他被诊断出在第三中段有一个简单的移位性锁骨骨折。该患者以前没有手术或医疗问题,也没有吸烟。没有家族凝血史,并且对称对侧的神经血管检查正常。用八字形绷带支撑手臂,患者出院。一个星期后,他的左臂肿胀而剧烈疼痛。检查时,怀疑是DVT,并移除了8字形支架。进行了多普勒超声检查,发现存在从肱腋静脉延伸到锁骨下静脉远端的血栓,在该段没有血流。将患者放在吊带中而不是8位图形绷带上,以固定手臂,同时开始使用依诺肝素进行抗凝治疗(每12小时1 mg / kg,每天皮下注射80 mg,持续3个月)。 5天后肿胀减轻。在2周的随访中,患者没有疼痛,肿胀完全消失了。

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