PMC5730392_01
Showing multiple bite marks with associated crush injury to the arm.
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PMC5730392_01_gr1.jpg
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And she sustained severe bites to left arm (minimal) and severe bites to her right axilla and upper arm (Fig. 1). At surgery, the axilla was explored and the axillary vein was found to be completely severed (the source of the hemorrhage) and there was a 5 cm length of contused axillary artery which was crushed and thrombosed (Fig. 1).
Distal arterio venous anastomosis using autogenous reverse vein.
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PMC5730392_02
Intraoperative picture showing the thrombosed brachial artery with surrounding nerves and veins.
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PMC5730392_02_gr5.jpg
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The axillary and brachial arteries were isolated and the axillary artery was noted to be crushed with no blood flow distal to this segment due to severe thrombosis (Fig. 5, Fig. 6).
Healed fasciotomy scar on forearm.
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PMC5730392_02_gr7.jpg
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There was eventual recovery of power and sensation to the affected fingers and the patient could use his hand and at review 3 years after injury has recovered full use of his right hand after resolution of his wrist-drop (Fig. 7).