warfarin and Arm-Injuries

Compartment syndrome can be a complication of warfarin treatment after a minor trauma. We report a case of an elderly woman who had an uncontrolled, high Internationalised Normalized Ratio (INR) level and had incurred a large haematoma on the left upper arm after a fall. After two days, the patient developed a massive oedema and clinical compartment syndrome. It is essential to be aware of symptoms and signs of compartment ischaemia, as early fasciotomy can prevent late complications such as muscle necrosis and contracture or at worst amputation. The patient should be hospitalized for observation for compartment syndrome and control of the INR level.

Topics: Aged, 80 and over; Anticoagulants; Arm Injuries; Compartment Syndromes; Fasciotomy; Female; Hematoma; Humans; International Normalized Ratio; Upper Extremity; Warfarin

Inferior shoulder dislocation or luxatio erecta is an exceedingly rare form of shoulder dislocation and compromises less than 0.5% of all shoulder dislocations. Furthermore, bilateral luxatio erecta is reported only nine times in the English literature. This paper documents the tenth case of bilateral luxatio erecta. This tenth patient suffered an axial load injury to his outstretched arms and displaced both humeral heads inferiorly. After closed reduction, the patient was discharged home on hospital day two. However, he developed an axillary vein thrombosis 3 days later and required anticoagulation therapy. This report reviews the mechanisms of injury associated with inferior shoulder dislocations as well as the presentation and treatment of luxatio erecta. The complication of axillary vein thrombosis and its treatment in this patient are discussed also.

Topics: Accidents, Traffic; Adult; Anticoagulants; Arm Injuries; Axillary Vein; Drug Therapy, Combination; Emergencies; Follow-Up Studies; Heparin, Low-Molecular-Weight; Humans; Male; Manipulation, Orthopedic; Postoperative Complications; Radiography; Shoulder Dislocation; Ultrasonography, Doppler; Venous Thrombosis; Warfarin; Weight-Bearing; Wounds, Nonpenetrating

Topics: Aged; Anticoagulants; Aortic Valve; Arm; Arm Injuries; Compartment Syndromes; Heart Valve Prosthesis; Hematoma; Humans; Long-Term Care; Male; Nerve Compression Syndromes; Nerve Regeneration; Neurologic Examination; Paralysis; Rupture; Tendon Injuries; Warfarin