NEUROLOGICAL AND VASCULAR COMPLICATIONS ASSOCIATED WITH SUPRACONDYLAR HUMERAL FRACTURES IN CHILDREN

The prevalence of neurological injuries in patients with displaced supracondylar humeral fractures is 10% to 20%. The prevalence of vascular injury in patients with displaced supracondylar humeral fractures is 15%. Isolated nerve injuries can commonly be observed without surgical exploration, resulting in nerve recovery over time. In the ischemic extremity, emergent reduction and pinning is necessary, with reassessment of the vascular status after reduction. In patients with a perfused, pulseless extremity following a supracondylar humeral fracture, prompt reduction and pinning is recommended. If the extremity remains well perfused but the pulse does not return, continued observation is recommended. For cases in which a palpable pulse does not return after reduction in a patient with a perfused, pulseless extremity following a supracondylar humeral fracture, many authors have recommended surgical exploration if there is a lack of a normal Doppler signal, if there is an associated median nerve palsy, or if perfusion is inadequate based on clinical observation of capillary refill, color, and warmth.