Publication details

Strategy of pulseless pink supracondylar humerus fracture treatment in children: a comparison of two approaches.

Authors

ŠTICHHAUER Radek PREIS Jindřich PLÁNKA Ladislav TUREK Jakub URBAN Jiří HORÁK Zbyněk ZEMAN Jaroslav KONEČNÝ Martin KOPÁČEK Ivo HANÁK Filip VOJTA Jiří CHRENKOVÁ Veronika

Year of publication 2022
Type Article in Periodical
Magazine / Source European Journal of Trauma and Emergency Surgery
MU Faculty or unit

Faculty of Medicine

Citation
Web https://link.springer.com/article/10.1007%2Fs00068-021-01794-x
Doi http://dx.doi.org/10.1007/s00068-021-01794-x
Keywords Supracondylar humerus fracture; Children; Pulseless; Pink; Vascular surgery
Description Purpose The appropriate treatment of pulseless pink supracondylar humerus fractures (SCHF) remains controversial. In this study, the outcomes of two treatment approaches (with and without vascular surgery) were compared. Material and methods This was a retrospective multicenter study of patients with pulseless pink SCHFs treated in ten pediatric surgery, trauma, or orthopedics departments in the Czech and Slovak Republic between 2014 and 2018. Results Of the total 3608 cases of displaced SCHF, 125 had the pulseless pink SCHF. Of those, 91% (114/125) did not undergo vascular surgery and 9% (11/125) underwent vascular surgery. The patients who did undergo vascular surgery had radial artery pulsation restored more frequently in the operating room (73% vs. 36%; p = 0.02), within 6 h (91% vs. 45%; p = 0.004), and within 24 h of surgery (91% vs. 57%; p = 0.05). However, 72 h after surgery, there was no significant difference in palpable radial artery pulsation between the vascular surgery and the non-vascular surgery groups (91% vs. 74%; p = 0.24). Additionally, no significant differences in long-term neurological (9% vs. 22%; p = 0.46) or circulatory (9% vs. 7%; p = 0.57) deficits were found between the two groups. Conclusion While vascular surgery in patients with pulseless pink SCHFs is associated with a more prompt restoration of radial artery pulsation, no statistical significant differences in terms of the restoration of neurological deficits or the risks of long-term neurological or circulatory deficits were found between patients with and without vascular surgery.

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