A 32-year-old patient suffered from progredient intermittent claudication of the left arm 6 months after plate fixation of a midshaft clavicular fracture (OTA classification type A). The radiological analysis revealed a subacute stenosis of the left subclavian artery, caused by a granuloma at the tip of a protruding screw, which triggered recurrent emboli and symptoms. Reperfusion was achieved by catheter embolectomy and complete removal of the plate. The case shows that, when performing plate osteosynthesis of clavicular fractures, special consideration has to be given to the length and protrusion of the applied screws. Due to the anatomic proximity not only acute, but also subsequent irritation of the subclavian vessels is possible.
Georg Thieme Verlag KG Stuttgart · New York.