• Neil Valentin Vega Peña, Manuel Riveros Dueñas, and Angie Carolina Riscanevo.
• Department of General Surgery, Clínica Reina Sofía, Colsanitas, Bogotá, Colombia.
• Colomb Medica. 2020 Sep 30; 51 (3): e504386.

Case DescriptionA 24-year-old male suffers from a motor vehicle accident with penetrating neck trauma and concomitant closed left cervicothoracic trauma.Clinical FindingsHigh 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 OutcomeAxillary 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 RelevanceThe 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.Copyright © 2020 Colombia Medica.

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