1.Early Vessels Exploration of Pink Pulseless Hand in Gartland III Supracondylar Fracture Humerus in Children: Facts and Controversies
Tunku-Naziha TZ ; Wan-Yuhana WMS ; Hadizie D ; Muhammad-Paiman ; Abdul-Nawfar S, M ; Wan-Azman WS ; Arman-Z MS ; Abdul-Razak S ; Rhendra-Hardy MZ ; Wan-Faisham WI
Malaysian Orthopaedic Journal 2017;11(1):12-17
The management of pink pulseless limbs in supracondylar
fractures has remained controversial, especially with regards
to the indication for exploration in a clinically well-perfused
hand. We reviewed a series of seven patients who underwent
surgical exploration of the brachial artery following
supracondylar fracture. All patients had a non-palpable radial
artery, which was confirmed by Doppler ultrasound. CT
angiography revealed complete blockage of the artery with
good collateral and distal run-off. Two patients were more
complicated with peripheral nerve injuries, one median
nerve and one ulnar nerve. Only one patient had persistent
arterial constriction which required reverse saphenous graft.
The brachial arteries were found to be compressed by
fracture fragments, but were in continuity. The vessels were
patent after the release of obstruction and the stabilization of
the fracture. There was no transection of major nerves. The
radial pulse was persistently present after 12 weeks, and the
nerve activity returned to full function.
Humerus
;
Fractures, Bone
Result Analysis
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