Vascular injury following supracondylar humerus fractures in children Çocuklarda suprakondiller humerus kırığı sonrası damarsal yaralanmalar


Özkul E., Gem M., Alemdar C., Arslan H., Azboy İ., Çelik V.

Ulusal Travma ve Acil Cerrahi Dergisi, cilt.22, sa.1, ss.84-89, 2016 (SCI-Expanded) identifier identifier

  • Yayın Türü: Makale / Tam Makale
  • Cilt numarası: 22 Sayı: 1
  • Basım Tarihi: 2016
  • Doi Numarası: 10.5505/tjtes.2015.83720
  • Dergi Adı: Ulusal Travma ve Acil Cerrahi Dergisi
  • Derginin Tarandığı İndeksler: Science Citation Index Expanded (SCI-EXPANDED), Scopus, TR DİZİN (ULAKBİM)
  • Sayfa Sayıları: ss.84-89
  • Anahtar Kelimeler: Pulselessness, Supracondylar humerus fracture in child, Vascular injury
  • İstanbul Medipol Üniversitesi Adresli: Hayır

Özet

BACKGROUND: The aim of this study was to evaluate the outcomes of the children with absent distal pulses following supracondylar humerus fractures. METHODS: Forty-two pulseless hand patients who were treated due to supracondylar humerus fractures were evaluated retrospectively. The evaluation included symptoms presented at preoperative and postoperative neurological examinations, mechanism of injury, time from injury to presentation, time from injury to surgery, length of hospital stay, and postoperative complications. RESULTS: In 27 patients, radial pulse was palpated following reduction. A stream was identified in ten patients with Doppler, and no stream was identified in two patients. These two patients had no ischemia and they presented with a stream on Doppler one day after the surgery. Immediate vascular exploration was applied in three patients (7%) who retained ischemia after the reduction and was unable to present a stream on Doppler. One patient underwent primary suture, and the other two were managed with saphenous vein graft and primary repair. DISCUSSION: It is vital to re-evaluate patients presenting with a pulseless hand following supracondylar humerus fracture; the ones with no ischemia or ischemic sign should be closely followed, and the ones retaining ischemic signs should be managed with primary vascular repair.