Upper Limb Ischemia Secondary to Crutch-induced Arterial Thrombosis: A Case Management and Future Directions

Acute upper limb ischemia resulting from injury caused by chronic use of crutches is a rare event. Incorrect use of underarm crutches results in repeated compressions of the arterial segment and can cause localized trauma, leading to structural changes, formation of thrombus, and/or aneurysmal degeneration at the site, which in turn can lead to acute arterial obstruction. We present the case of a 53-year-old male with a history of chronic axillary crutch use due to childhood poliomyelitis who presented with acute right upper limb ischemia. Computed tomography angiography identified a right upper limb occlusion and was treated with a vein graft bypass. After recovery, he was guided and trained with special prosthesis to prevent recurrent thrombosis and subsequent embolization. This case report is intended to call attention to the type of clinical presentation found in this rare form of upper limb arterial occlusion and the importance of its prevention.