Management of Pulseless Upper Limb in Supracondylar Fracture Humerus in Children

Document Type : Original Article

Authors

Vascular Surgery, Faculty of Medicine for Boys, Al-Azhar University, Cairo, Egypt

/10.21608/aimj.2025.446462

Abstract

Aim: To develop an appropriate management strategy for children with a supracondylar humerus fracture who have a pulseless but well-perfused hand after the fracture has been reduced and fixed.‎
Subjects and methods: This study was conducted on 30 children with supracondylar fracture of the humerus and pulseless hand. The study took place at the Orthopedic Department at Al-Azhar University and Saidnawy Hospital.
Results: The physical examination indicated six fractures, each accompanied by a neurological deficiency. Out of the six fractures, four (13.3%) resulted in median nerve palsy, one (3.3%) resulted in radial nerve palsy, and one (3.3%) resulted in ulnar nerve palsy. All patients (100%) showed intact arterial continuity with no evidence of rupture or transection, as confirmed by postoperative duplex ultrasonography. Every patient included in the study (100%) experienced neurological improvement during the follow-up period after the surgery. There was a varus deformity in only one case, accounting for 3.3% of the total.
Conclusion: Immediate investigation is necessary for children with supracondylar fractures of the humerus accompanied by a warm and pulseless hand. Treating children with pink, warm hands and good capillary refill through stabilization using K-wires and observation is a viable treatment option. This approach eliminates the need for early revascularization procedures, which can lead to a high incidence of asymptomatic reocclusion and residual stenosis of the brachial artery exploration.‎

Keywords

Al-Azhar International Medical Journal
Volume 2025, Issue 1
January 2025
Pages 245-249

Files

Share

How to cite

Statistics