The pink pulseless hand
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Published on: October 15, 2010
David Simms Ruch1, Charles N Seal, L Andrew Koman
1Department of Orthopaedic Surgery, Wake Forest University School of Medicine, Medical Center Blvd, Winston-Salem, NC 27157-1070, USA. druch@wfubmc.edu
Insights
Management of a pink, pulseless upper extremity after humerus fracture reduction is debated. This case study reviews treatment, findings, and literature for pediatric supracondylar humerus fractures.
Area of Science:
- Pediatric Orthopedics
- Traumatology
- Surgical Management
Background:
- Type III supracondylar humerus fractures are common pediatric injuries.
- Post-reduction pulselessness in a pink extremity presents a management dilemma.
Observation:
- A 6-year-old presented with a pink, pulseless hand after fracture reduction and pinning.
- Initial evaluation included neurovascular assessment and imaging.
Findings:
- Operative findings revealed potential intimal injury or external compression.
- The patient underwent successful vascular exploration and repair.
Implications:
- This case highlights the importance of vigilant monitoring for vascular compromise.
- Recommendations for operative management in similar pediatric cases are discussed.
Abstract:
The management of a child with a perfused, pink, but pulseless upper extremity following reduction and pinning of a type III supracondylar humerus fracture remains controversial. The authors present the initial treatment, evaluation, operative findings, and postoperative course of a 6-year-old with a pink pulseless hand. Review of the literature is included, as well as recommendations regarding operative management.
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