MANAGEMENT OF SUPRACONDYLAR FRACTURE HUMERUS WITH Pink Pulseless Hand in Children. | ||
| Sohag Medical Journal | ||
| Article 48, Volume 22, Issue 1, January 2018, Pages 337-341 PDF (53.84 K) | ||
| Document Type: Original Article | ||
| DOI: 10.21608/smj.2018.41979 | ||
| Authors | ||
| Mohamed Atea1; Ashraf Rashad Ahmed1; Ahmed I. Eldosoky2; Mohamed El saed Abdel-Wanis2 | ||
| 1Department of Orthopedics, Sohag University ,Sohag , Egypt. | ||
| 2Department of Orthpaedic and Traumatology , Faculty of Medicine, Sohag University. | ||
| Abstract | ||
| The management of children with a pink pulseless hand in severely displaced supracondylar humeral fractures remains controversial regarding immediate exploration of the brachial artery and revascularization during fracture fixation or just closed reduction of the fracture and percutaneous pinning and follow up of limb perfusion.Between 2012 and 2016 we followed 52 children with displaced supracondylar fracture humerus. All patients had absent radial pulse with an otherwise well perfused hand. The radial pulse was returned in all patients, without surgical exploration after closed reduction of the fracture and percutaneous pinning .It takes variable periods from 1week to 2 months . Radial pulse recovery may be due to recanalization of brachial artery or by collaterals. So closed reduction of the fracture, percutaneous pinning and observation is a good option of treatment pediatric supracondylar humeral fractures with a pink pulseless hand without need to do early revascularization procedures. | ||
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| References | ||
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1. Noaman HH, . Microsurgical reconstruction of brachial artery injuries in displaced supracondylar fracture humerus in children. J Microsurgery 2006 .26:498-505 2. 2.Lee YH, Lee SK, Kim BS, Chun MS, Baek GH, Gong HS. Three lateral divergent or parallel pin fixations for the treatment of displaced supracondylar humerus fractures in children. J Pediatr Orthop 2008;28:417-422. 3. Schoenecker PL, Delgado E, Rotman M, Sicard GA, Capelli AM(1996) Pulseless arm in association with totally displaced supracondylar fracture. J Orthop Trauma 10:410–415 4. Campbell CC, Waters PM, Emans JB, Kasser JR, Millis MB (1995) Neurovascular injury and displacement in type III supracondylar humerus fractures. J Pediatr Orthop 15:47–52 toward a goal of prevention. J Pediatr Orthop 16:99–103 5. Culp RW, Osterman AL, Davidson RS, Skirven T, Bora FW Jr(1990) Neural injuries associated with supracondylar fractures of the humerus in children. J Bone Joint Surg Am 72:1211–1215 6. Brown IC, Zinar DM (1995) Traumatic and iatrogenic neurological complications after supracondylar humerus fractures in children. J Pediatr Orthop 15:440–443 7. Ristic S, Strauch RJ, Rosenwasser MP (2000) The assessment and treatment of nerve dysfunction after trauma around the elbow. Clin Orthop Relat Res 370:138–153 8. Wilkins (1996) Fractures and dislocations of the elbow region. In: Rockwood CA,Wilkins KE, King RE (eds) Fractures in children, vol 3, 4th edn. Lippincott-Raven, Philadelphia, pp 363–575 9. Felsenreich F (1931) Kindlichesuprakondylarefrakturen und posttraumatische deformitäten des ellebo engelenk. 10. Gartland JJ (1959) Management of supracondylar fractures of the humerus in children. Surg Gynecol Obstet 109:145–154 11. Garbuz DS, Leitch K, Wright LG (1996) The treatment of supracondylar fractures in children with an absent radial pulse. J Pediatr Orthop 16:594–596 12. Gosens T, Bongers KJ (2003) Neurovascular complications and functional outcome in displaced supracondylar fractures of the humerus in children. Injury 34:267–273 13. Malviya A, Simmons D, Vallamshetla R, Bache CE (2006) Pink pulseless hand following supracondylar fractures: an audit of British practice. J Pediatr Orthop B 15:62–64 14. Sabharwal S, Tredwell SJ, Beauchamp RD, Mackenzie WG, Jakubec DM, Cairns R, LeBlanc JG (1997) Management of pulseless pink hand in pediatric supracondylar fractures of humerus. J Pediatr Orthop 17:303–310 15. Shaw BA, Kasser JR, Emans JB, Rand FF (1990) Management of vascular injuries in displaced supracondylar humerus fractures without arteriography. J Orthop Trauma 4:25–29 16. Pirone AM, Graham HK, Krajbich JI (1988) Management of displaced extension-type supracondylar fractures of the humerus in children. J Bone Joint Surg Am 70:641–650 17. Marck KW, Kooijman AM, Binnendijk B (1986) Brachial artery rupture following supracondylar fracture of the humerus. Neth J Surg 38:81–84 18. Broudy S, Jupiter J, May JW Jr (1979) Management of supracondylar fracture with brachial artery thrombosis in a child: case report and literature review. J Orthop Trauma 19:540–554 19. Ramachandran M, Birch R, Eastwood DM (2006) Clinical outcome of nerve of injuries associated with supracondylar fractures the humerus in children: the experience of a specialist referral centre. J Bone Joint Surg Br 88:90–94 20. Garbuz DS, Leitch K, Wright LG. The treatment of supracondylar fractures in children with an absent radial pulse. J Pediatr Orthop. 1996;16:594–596. 21. Malviya A, Simmons D, Vallamshetla R, Bache CE. Pink pulseless hand following supracondylar fractures: an audit of British practice. J Pediatr Orthop B. 2006;15:62–64. 22. Sabharwal S, Tredwell SJ, Beauchamp RD, Mackenzie WG, Jakubec DM, Cairns R, LeBlanc JG. Management of pulseless pink hand in pediatric supracondylar fractures of humerus. J Pediatr Orthop. 1997;17:303–310. doi: 10.1097/00004694-199705000-00007. | ||
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