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Case Description:


A 24-year-old male suffers from a motor vehicle accident with penetrating neck trauma and concomitant closed left cervicothoracic trauma.




Clinical Findings:


High impact trauma causing hypovolemic shock, left zone I penetrating neck trauma, ischemia due to blunt trauma to the axillary vessels, and brachial plexus injury. Transection of the vertebral artery on angiotomography. Diagnosed with scapulothoracic dissociation and vertebral artery trauma.




Treatment and outcome:


Axillary arteriovenous reconstruction, fasciotomies, non-surgical approach of the vertebral artery trauma, and deferred treatment of the brachial plexus trauma were performed. Survival of the patient and his limb, with major neurologic sequelae




Clinical Relevance:


The case presented here is an example of scapulothoracic dissociation with associated trauma to the vertebral artery, injuries that are uncommon and associated with high morbidity and mortality. Early recognition of the injuries and a multidisciplinary approach for this complex case by surgical board reviews at various levels within the course of care were key determinants in the patient’s improved prognosis. This case report presents an analysis of the diagnostics, treatment, and course; considering in-hospital care and the decision-making process as determinants for the prognosis in a polytrauma patient.


Neil Valentin Vega Peña, Clínica Reina Sofía, Colsanitas

Médico especialista en Cirugia, MSc Epidemiologia. Cirujano adscrito, Departamento de Cirugía General, Clínica Reina Sofía, Colsanitas. Bogotá-Colombia

orcid_id14.png https://orcid.org/0000-0003-4682-5852

Manuel Riveros Dueñas, Clínica Reina Sofía, Colsanitas

Médico especialista en Cirugía. Cirujano adscrito Departamento de Cirugía General, Clínica Reina Sofía, Colsanitas. Bogotá-Colombia

orcid_id14.pnghttps://orcid.org/0000-0003-1858-7869

Angie Carolina Riscanevo Bobadilla, Clínica Reina Sofia Colsanitas grupo Keralty

Médico general Departamento de Cirugía General, Clínica Reina Sofía, Colsanitas. Bogotá-Colombia. 

orcid_id14.png ORCID: orcid.org/0000-0002-3224-5729

Vega Peña, N. V., Dueñas, M. R., & Riscanevo Bobadilla, A. C. (2020). Scapulothoracic dissociation and blunt vertebral vascular injury: case report. Colombia Medica, 51(3), e–504386. https://doi.org/10.25100/cm.v51i3.4386

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Received 2020-06-16
Accepted 2020-09-10
Published 2020-09-22