Although most fractures of the clavicle are usually treated by closed means and heal uneventfully, serious injuries may occur and a delay in treateng these injuries may be life-threatening. One of such serious associated injuries is vascular injury. In this report, we present an unusual case in which a fracture of the clavicle was accompanied by an injury of the subclavian artery, hemothorax and concommitant arterial occlusion of upper extremity by throboernbolism. Treatment included resection of the injured part of the artery with bypass graft, thromboembolectomy and fixation of the clavicle with a plate and screws. Thereafter, the patient had suffered from repeated episodes of thrornboembolism of the upper extremity, a compartment syrdrome and a metal failure.

It is critical in a patient with a clavicular fracture that a careful examination of the entire upper extremity be performed, with particular emphasis on the neurovascualr status.