![]() Failure to assess a distal pulse in a patient may result in the loss of thechild’s limb. In evaluation of supracondylar fractures of the humerus, the physician must pay close attention to the neurovascular exam ( 1). ![]() Prevention of these complications depends largely on a timely diagnosis, aggressive treatment, and a high index of suspicion in a child with a suggestive history and physical exam. The anterior interosseous nerve, a branch of the median nerve being most commonly involved (20-45% of all nerve injuries) ( 1). Non-vascular complications include deformity and neurologic injury (median, ulnar, and radial nerves). Another possible long-term vascular complication is limb claudication (due to inadequate repair of the brachial artery or distal thrombus migration, with impeded blood flow) ( 2). The dreaded vascular complications include brachial artery occlusion and possible limb loss, compartment syndrome or, Volkmann’s contracture ( 1). ![]() Arterial injury ranges anywhere from vascular contusion and intimal damage, to complete arterial transection ( 5, 6). The incidence of vascular injury in children after a completely displaced supracondylar fracture has been reported to be around 12%, with the brachial artery being most commonly involved (38% of all cases in Campbell et al. Not only is this type of fracture relevant because of the frequency in which it is encountered, but more importantly, because of its high complication rate seen secondary to vascular injury. Due to the frequency of falls, 65-75% of all fractures in this age group affect the upper extremities ( 2). It mostly occurs by falling on an out-stretched hand (FOOSH) ( 1). Supracondylar fracture of the humerus is the most common fracture of the elbow in the pediatric population (60%).
0 Comments
Leave a Reply. |
AuthorWrite something about yourself. No need to be fancy, just an overview. ArchivesCategories |