Objective To summary the therapeutic method and clinical effect of supracondylar fractures of the humerus with pulseless hand in children. Methods A total of 45 patients of humeral supracondylar fracture with pulseless hands were hospitalized and followed up for more than one year from January 2010 to June 2018. There were 23 boys, with an average age of 5 years and 8 months. There were 22 girls, with an average age of 5 years and 6 months. There were 36 cases of fall injury, 4 cases of electric vehicle falls, 3 cases of high fall, and 1 case of traffic accident. All cases were Gartland type III fractures. Closed reduction and Kirschner wire fixation were performed in 18 cases, and open exploration of blood vessels and fracture reduction with Kirschner wire fixation in 27 cases. Arterial pulse and the presence or absence of perfusion were evaluated by Doppler. Plaster and Kirschner wire were removed 4 weeks after surgery. Results The children were followed up for 12 to 15 months, with an average follow-up of 13 months. The fractures all healed around 4-12 weeks. According to Flynn evaluation standard of elbow performance score: excellent in 42 cases and good in 3 cases. At the last follow-up, the radial artery pulsation was good, and there were no complications such as redisplacement, pin tract infections and cubitus varus. Conclusions The pale hand should be explored the vessels immediately, and the failed closed reduction. Radial arterial pulsation should be closely observed within 48 h after closed reduction and Kirschner wire fixation for pink hand. Blood vessels should be opened for exploration, fracture reduction and fixation for those who failed closed reduction or had differences between preoperative and postoperative Doppler examination. After reduction of the supracondylar fracture of the humerus, attention should be paid to the presence or absence of radial artery pulsation.
Key words
Supracondylar humeral fractures /
Pulesless /
Fixation /
Children
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