Pregled bibliografske jedinice broj: 1279091
Intermittent claudications of the hand after supracondylar humeral fracture in a 2-year old boy
Intermittent claudications of the hand after supracondylar humeral fracture in a 2-year old boy // Liječnički vijesnik
Zagreb, Hrvatska, 2023. str. 56-56 doi:10.26800/LV-145-supl2-CR20 (poster, podatak o recenziji nije dostupan, sažetak, stručni)
CROSBI ID: 1279091 Za ispravke kontaktirajte CROSBI podršku putem web obrasca
Naslov
Intermittent claudications of the hand after supracondylar humeral
fracture in a 2-year old boy
Autori
Knez, Nora ; Jeričević, Karmen ; Kelčec, Luka ; Vlahek, Tomislav ; Papeš, Dino
Vrsta, podvrsta i kategorija rada
Sažeci sa skupova, sažetak, stručni
Izvornik
Liječnički vijesnik
/ - , 2023, 56-56
Skup
CROSS18
Mjesto i datum
Zagreb, Hrvatska, 25.04.2023. - 28.04.2023
Vrsta sudjelovanja
Poster
Vrsta recenzije
Podatak o recenziji nije dostupan
Ključne riječi
brachial artery ; children ; neurovascular injuries ; supracondylar humeral fracture
Sažetak
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 well- perfused 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.
Izvorni jezik
Engleski
