Pulseless Arm in Association with Totally Displaced Supracondylar Fracture
SUMMARYSeven children (3-10 years of age) were treated for a type III supracondylar fracture of the humerus. All fractures were reduced and pinned. Closed redcuction was performed in four patients; three required open reduction. Before reduction six of the seven patients did not have a distal palpab...
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Veröffentlicht in: | Journal of orthopaedic trauma 1996-01, Vol.10 (6), p.410-415 |
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description | SUMMARYSeven children (3-10 years of age) were treated for a type III supracondylar fracture of the humerus. All fractures were reduced and pinned. Closed redcuction was performed in four patients; three required open reduction. Before reduction six of the seven patients did not have a distal palpable pulse in the involved forearm. After reduction of the fractures all patients had a pulseless arm and a seemingly viable hand. Doppler pulses were absent or greatly diminished compared with the normal side in all involved extremities. Six patients underwent immediate antecubital fossa exploration of the brachial artery without arteriogram; one patient, referred to us from another facility, underwent angiography followed by immediate exploration. In three patients the brachial artery was directly damaged or transected and was repaired via saphenous vein graft, with reestablishment of distal pulses in each case. In the other four patients the brachial artery was kinked or entrapped at the fracture site, necessitating microdissection to mobilize the vessel and reestablish pulses in each case. At an average follow-up of 30 months, all seven patients had normal circulatory status, including a radial pulse. All fractures had healed, and all extremities had a normal carrying angle and normal elbow motion. Immediate exploration of the antecubital fossa should be considered if an extremity remains pulseless (to palpation and Doppler) after reduction and stabilization of significantly displaced supracondylar fractures of the humerus. |
doi_str_mv | 10.1097/00005131-199608000-00008 |
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All fractures were reduced and pinned. Closed redcuction was performed in four patients; three required open reduction. Before reduction six of the seven patients did not have a distal palpable pulse in the involved forearm. After reduction of the fractures all patients had a pulseless arm and a seemingly viable hand. Doppler pulses were absent or greatly diminished compared with the normal side in all involved extremities. Six patients underwent immediate antecubital fossa exploration of the brachial artery without arteriogram; one patient, referred to us from another facility, underwent angiography followed by immediate exploration. In three patients the brachial artery was directly damaged or transected and was repaired via saphenous vein graft, with reestablishment of distal pulses in each case. In the other four patients the brachial artery was kinked or entrapped at the fracture site, necessitating microdissection to mobilize the vessel and reestablish pulses in each case. At an average follow-up of 30 months, all seven patients had normal circulatory status, including a radial pulse. All fractures had healed, and all extremities had a normal carrying angle and normal elbow motion. Immediate exploration of the antecubital fossa should be considered if an extremity remains pulseless (to palpation and Doppler) after reduction and stabilization of significantly displaced supracondylar fractures of the humerus.</description><identifier>ISSN: 0890-5339</identifier><identifier>EISSN: 1531-2291</identifier><identifier>DOI: 10.1097/00005131-199608000-00008</identifier><identifier>PMID: 8854319</identifier><language>eng</language><publisher>Hagerstown, MD: Lippincott-Raven Publishers</publisher><subject>Algorithms ; Biological and medical sciences ; Bone Nails ; Bone Wires ; Brachial Artery - injuries ; Brachial Artery - surgery ; Child ; Child, Preschool ; Fracture Fixation ; Fractures, Closed - complications ; Fractures, Closed - surgery ; Fractures, Open - complications ; Fractures, Open - surgery ; Humans ; Humeral Fractures - complications ; Humeral Fractures - surgery ; Injuries of the limb. Injuries of the spine ; Laser-Doppler Flowmetry ; Medical sciences ; Multiple Trauma - diagnosis ; Pulse ; Traumas. Diseases due to physical agents</subject><ispartof>Journal of orthopaedic trauma, 1996-01, Vol.10 (6), p.410-415</ispartof><rights>Lippincott-Raven Publishers</rights><rights>1996 INIST-CNRS</rights><lds50>peer_reviewed</lds50><woscitedreferencessubscribed>false</woscitedreferencessubscribed><citedby>FETCH-LOGICAL-c3848-fe78abe5b7047e55f1dade07d5f52dba9b17d4871a77b5ae15b5a74797fbd0b33</citedby><cites>FETCH-LOGICAL-c3848-fe78abe5b7047e55f1dade07d5f52dba9b17d4871a77b5ae15b5a74797fbd0b33</cites></display><links><openurl>$$Topenurl_article</openurl><openurlfulltext>$$Topenurlfull_article</openurlfulltext><thumbnail>$$Tsyndetics_thumb_exl</thumbnail><link.rule.ids>314,780,784,27924,27925</link.rule.ids><backlink>$$Uhttp://pascal-francis.inist.fr/vibad/index.php?action=getRecordDetail&idt=3184808$$DView record in Pascal Francis$$Hfree_for_read</backlink><backlink>$$Uhttps://www.ncbi.nlm.nih.gov/pubmed/8854319$$D View this record in MEDLINE/PubMed$$Hfree_for_read</backlink></links><search><creatorcontrib>Schoenecker, Perry L</creatorcontrib><creatorcontrib>Delgado, Eliana</creatorcontrib><creatorcontrib>Rotman, Mitchell</creatorcontrib><creatorcontrib>Sicard, Gregorio A</creatorcontrib><creatorcontrib>Capelli, Ann M</creatorcontrib><title>Pulseless Arm in Association with Totally Displaced Supracondylar Fracture</title><title>Journal of orthopaedic trauma</title><addtitle>J Orthop Trauma</addtitle><description>SUMMARYSeven children (3-10 years of age) were treated for a type III supracondylar fracture of the humerus. All fractures were reduced and pinned. Closed redcuction was performed in four patients; three required open reduction. Before reduction six of the seven patients did not have a distal palpable pulse in the involved forearm. After reduction of the fractures all patients had a pulseless arm and a seemingly viable hand. Doppler pulses were absent or greatly diminished compared with the normal side in all involved extremities. Six patients underwent immediate antecubital fossa exploration of the brachial artery without arteriogram; one patient, referred to us from another facility, underwent angiography followed by immediate exploration. In three patients the brachial artery was directly damaged or transected and was repaired via saphenous vein graft, with reestablishment of distal pulses in each case. In the other four patients the brachial artery was kinked or entrapped at the fracture site, necessitating microdissection to mobilize the vessel and reestablish pulses in each case. At an average follow-up of 30 months, all seven patients had normal circulatory status, including a radial pulse. All fractures had healed, and all extremities had a normal carrying angle and normal elbow motion. Immediate exploration of the antecubital fossa should be considered if an extremity remains pulseless (to palpation and Doppler) after reduction and stabilization of significantly displaced supracondylar fractures of the humerus.</description><subject>Algorithms</subject><subject>Biological and medical sciences</subject><subject>Bone Nails</subject><subject>Bone Wires</subject><subject>Brachial Artery - injuries</subject><subject>Brachial Artery - surgery</subject><subject>Child</subject><subject>Child, Preschool</subject><subject>Fracture Fixation</subject><subject>Fractures, Closed - complications</subject><subject>Fractures, Closed - surgery</subject><subject>Fractures, Open - complications</subject><subject>Fractures, Open - surgery</subject><subject>Humans</subject><subject>Humeral Fractures - complications</subject><subject>Humeral Fractures - surgery</subject><subject>Injuries of the limb. Injuries of the spine</subject><subject>Laser-Doppler Flowmetry</subject><subject>Medical sciences</subject><subject>Multiple Trauma - diagnosis</subject><subject>Pulse</subject><subject>Traumas. Diseases due to physical agents</subject><issn>0890-5339</issn><issn>1531-2291</issn><fulltext>true</fulltext><rsrctype>article</rsrctype><creationdate>1996</creationdate><recordtype>article</recordtype><sourceid>EIF</sourceid><recordid>eNp1kUtPAyEUhYnRaK3-BBMWxt0oDIPAsvFtTDSxrsmd4U46SmcqzKTpv5fa2p0seJz73UM4EEI5u-TMqCuWhuSCZ9yYa6bTKVtLeo-MuExynhu-T0ZMG5ZJIcwROY7xc02wPD8kh1rLQnAzIs9vg4_oMUY6CXPatHQSY1c10DddS5dNP6PTrgfvV_S2iQsPFTr6PiwCVF3rVh4CvU_7fgh4Qg5qSGan23VMPu7vpjeP2cvrw9PN5CWrhC50VqPSUKIsFSsUSllzBw6ZcrKWuSvBlFy5QisOSpUSkMs0q0IZVZeOlUKMycXGdxG67wFjb-dNrNB7aLEbolW6yFlxzRKoN2AVuhgD1nYRmjmEleXMrmO0fzHaXYy_kk6tZ9s7hnKObte4zS3Vz7d1iBX4OkBbNXGHCZ5e-mtTbLBl53sM8csPSwx2huD7mf3vE8UP6mmKWQ</recordid><startdate>19960101</startdate><enddate>19960101</enddate><creator>Schoenecker, Perry L</creator><creator>Delgado, Eliana</creator><creator>Rotman, Mitchell</creator><creator>Sicard, Gregorio A</creator><creator>Capelli, Ann M</creator><general>Lippincott-Raven Publishers</general><general>Lippincott Williams & Wilkins</general><scope>IQODW</scope><scope>CGR</scope><scope>CUY</scope><scope>CVF</scope><scope>ECM</scope><scope>EIF</scope><scope>NPM</scope><scope>AAYXX</scope><scope>CITATION</scope><scope>7X8</scope></search><sort><creationdate>19960101</creationdate><title>Pulseless Arm in Association with Totally Displaced Supracondylar Fracture</title><author>Schoenecker, Perry L ; Delgado, Eliana ; Rotman, Mitchell ; Sicard, Gregorio A ; Capelli, Ann M</author></sort><facets><frbrtype>5</frbrtype><frbrgroupid>cdi_FETCH-LOGICAL-c3848-fe78abe5b7047e55f1dade07d5f52dba9b17d4871a77b5ae15b5a74797fbd0b33</frbrgroupid><rsrctype>articles</rsrctype><prefilter>articles</prefilter><language>eng</language><creationdate>1996</creationdate><topic>Algorithms</topic><topic>Biological and medical sciences</topic><topic>Bone Nails</topic><topic>Bone Wires</topic><topic>Brachial Artery - injuries</topic><topic>Brachial Artery - surgery</topic><topic>Child</topic><topic>Child, Preschool</topic><topic>Fracture Fixation</topic><topic>Fractures, Closed - complications</topic><topic>Fractures, Closed - surgery</topic><topic>Fractures, Open - complications</topic><topic>Fractures, Open - surgery</topic><topic>Humans</topic><topic>Humeral Fractures - complications</topic><topic>Humeral Fractures - surgery</topic><topic>Injuries of the limb. Injuries of the spine</topic><topic>Laser-Doppler Flowmetry</topic><topic>Medical sciences</topic><topic>Multiple Trauma - diagnosis</topic><topic>Pulse</topic><topic>Traumas. Diseases due to physical agents</topic><toplevel>peer_reviewed</toplevel><toplevel>online_resources</toplevel><creatorcontrib>Schoenecker, Perry L</creatorcontrib><creatorcontrib>Delgado, Eliana</creatorcontrib><creatorcontrib>Rotman, Mitchell</creatorcontrib><creatorcontrib>Sicard, Gregorio A</creatorcontrib><creatorcontrib>Capelli, Ann M</creatorcontrib><collection>Pascal-Francis</collection><collection>Medline</collection><collection>MEDLINE</collection><collection>MEDLINE (Ovid)</collection><collection>MEDLINE</collection><collection>MEDLINE</collection><collection>PubMed</collection><collection>CrossRef</collection><collection>MEDLINE - Academic</collection><jtitle>Journal of orthopaedic trauma</jtitle></facets><delivery><delcategory>Remote Search Resource</delcategory><fulltext>fulltext</fulltext></delivery><addata><au>Schoenecker, Perry L</au><au>Delgado, Eliana</au><au>Rotman, Mitchell</au><au>Sicard, Gregorio A</au><au>Capelli, Ann M</au><format>journal</format><genre>article</genre><ristype>JOUR</ristype><atitle>Pulseless Arm in Association with Totally Displaced Supracondylar Fracture</atitle><jtitle>Journal of orthopaedic trauma</jtitle><addtitle>J Orthop Trauma</addtitle><date>1996-01-01</date><risdate>1996</risdate><volume>10</volume><issue>6</issue><spage>410</spage><epage>415</epage><pages>410-415</pages><issn>0890-5339</issn><eissn>1531-2291</eissn><abstract>SUMMARYSeven children (3-10 years of age) were treated for a type III supracondylar fracture of the humerus. All fractures were reduced and pinned. Closed redcuction was performed in four patients; three required open reduction. Before reduction six of the seven patients did not have a distal palpable pulse in the involved forearm. After reduction of the fractures all patients had a pulseless arm and a seemingly viable hand. Doppler pulses were absent or greatly diminished compared with the normal side in all involved extremities. Six patients underwent immediate antecubital fossa exploration of the brachial artery without arteriogram; one patient, referred to us from another facility, underwent angiography followed by immediate exploration. In three patients the brachial artery was directly damaged or transected and was repaired via saphenous vein graft, with reestablishment of distal pulses in each case. In the other four patients the brachial artery was kinked or entrapped at the fracture site, necessitating microdissection to mobilize the vessel and reestablish pulses in each case. At an average follow-up of 30 months, all seven patients had normal circulatory status, including a radial pulse. All fractures had healed, and all extremities had a normal carrying angle and normal elbow motion. Immediate exploration of the antecubital fossa should be considered if an extremity remains pulseless (to palpation and Doppler) after reduction and stabilization of significantly displaced supracondylar fractures of the humerus.</abstract><cop>Hagerstown, MD</cop><pub>Lippincott-Raven Publishers</pub><pmid>8854319</pmid><doi>10.1097/00005131-199608000-00008</doi><tpages>6</tpages></addata></record> |
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subjects | Algorithms Biological and medical sciences Bone Nails Bone Wires Brachial Artery - injuries Brachial Artery - surgery Child Child, Preschool Fracture Fixation Fractures, Closed - complications Fractures, Closed - surgery Fractures, Open - complications Fractures, Open - surgery Humans Humeral Fractures - complications Humeral Fractures - surgery Injuries of the limb. Injuries of the spine Laser-Doppler Flowmetry Medical sciences Multiple Trauma - diagnosis Pulse Traumas. Diseases due to physical agents |
title | Pulseless Arm in Association with Totally Displaced Supracondylar Fracture |
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