Supracondylar Humerus Fractures in Children With Vascular Compromise: A Report of Two Cases and Review of Literature

Supracondylar humerus fractures are the most common pediatric elbow fractures and may rarely be associated with vascular compromise. We present two pediatric cases of displaced left supracondylar humerus fractures complicated by arterial injury. A four-year-old boy developed absent radial and ulnar pulses following fracture fixation and underwent urgent thrombectomy with Fogarty catheterization using a Fogarty arterial embolectomy catheter (Edwards Lifesciences, Irvine, CA, USA), resulting in immediate restoration of distal perfusion. An 11-year-old girl presented with brachial artery entrapment within the fracture site and was successfully treated with surgical release and vascular repair. Both patients were managed with external fixation (DePuy Synthes, West Chester, PA, USA) and received postoperative weight-adjusted rivaroxaban (Xarelto®; Bayer AG, Leverkusen, Germany) as part of individualized postoperative management for three months. At follow-up, both patients demonstrated complete recovery of hand function with intact distal perfusion and no neurological deficits. These cases highlight the importance of early recognition of vascular compromise, prompt surgical intervention, and interdisciplinary management in preventing ischemic complications and optimizing functional recovery. However, evidence regarding postoperative anticoagulation in pediatric vascular trauma remains limited, and standardized protocols are currently lacking.