Entrapment of the brachial artery in the cancellous bone in pulseless supracondylar humerus fractures with well-perfused hands: Report of three cases

Creative Commons License

ERMUTLU C., SARISÖZEN M. B., DURAK K., ATICI T., ÇAKAR A.

Joint Diseases and Related Surgery, vol.33, no.3, pp.680-685, 2022 (SCI-Expanded) identifier identifier identifier identifier

  • Publication Type: Article / Article
  • Volume: 33 Issue: 3
  • Publication Date: 2022
  • Doi Number: 10.52312/jdrs.2022.591
  • Journal Name: Joint Diseases and Related Surgery
  • Journal Indexes: Science Citation Index Expanded (SCI-EXPANDED), Scopus, TR DİZİN (ULAKBİM)
  • Page Numbers: pp.680-685
  • Keywords: Antecubital approach, brachial artery, pulseless, supracondylar humerus fracture, MANAGEMENT
  • Bursa Uludag University Affiliated: Yes

Abstract

© 2022 All right reserved by the Turkish Joint Diseases FoundationManagement of pediatric pulseless supracondylar humerus fractures is a point of continuous debate. In this article, we present three cases admitted to the emergency department with pulseless, but well-perfused hands. The fractures were reduced and fixed using the antecubital approach. Prior to reduction, the brachial arteries of all three patients were entrapped in the cancellous bone of the proximal fragment segment. The arteries could only be released after freeing the adventitia by carefully scraping the adjacent bone with the tip of a hemostat. One case required thrombectomy through an arteriotomy using No. 3 Fogarty catheter. In two cases, the pulse returned after a brief period of waiting with no need for vascular intervention. Proceeding with closed reduction, as proposed by the recent guidelines, would result in further damage to the entrapped vasculature, which may go unnoticed due to collateral circulation.