| Autor: |
Knez, Nora, Jeričević, Karmen, Kelčec, Luka, Vlahek, Tomislav, Papeš, Dino |
| Předmět: |
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| Zdroj: |
Lijecnicki Vjesnik; 2023 Supplement, Vol. 145, p56-56, 1/2p |
| Abstrakt: |
INTRODUCTION/OBJECTIVES: Supracondylar humeral fractures (SHF) are the most common fractures associated with concomitant neurovascular injuries in children. Pink pulseless hand (PPH) labels SHF presenting without a pulse in a wellperfused hand. Management of PPH after successful SHF reduction remains controversial. Some advocate „watchful waiting”, whereas others favor early exploration. We present a case of a 2-year-old boy with PPH and intermittent claudications 6 weeks after successful SHF reduction. CASE PRESENTATION: A boy sustained a completely dislocated SHF after a fall. Examination revealed partial loss of median nerve innervation and PPH, which persisted after closed reduction and percutaneous pinning. Postoperative radial artery Doppler showed biphasic arterial waveform and lower flow velocities. Six weeks after the injury, the hand was cold and pale during minimal straining, and the patient avoided using his hand. CT angiography showed a thrombosed segment of the brachial artery in the cubital fossa. Surgical exploration revealed thrombosis of the brachial artery and the median entrapped in the fracture. The thrombosed segment was resected, and the defect was reconstructed with a reversed cephalic vein graft. The nerve was freed, and the partial defect was reconstructed with direct sutures. The postoperative course was uneventful, with full recovery of hand function, elbow movement, innervation, and palpable radial pulses six months following the injury. CONCLUSION: Although children with PPH after SHF do not require immediate brachial artery exploration, the absence of radial artery pulse several weeks after SHF requires careful follow-up and re-evaluation to avoid complications and ensure aproprate growth and function of the affected extremity. [ABSTRACT FROM AUTHOR] |
| Databáze: |
Complementary Index |
| Externí odkaz: |
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