• Eur J Trauma Emerg Surg · Oct 2022

    Multicenter Study

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

    • Radek Štichhauer, Jindřich Preis, Ladislav Plánka, Jakub Turek, Jiří Urban, Zbyněk Horák, Jaroslav Zeman, Martin Konečný, Ivo Kopáček, Filip Hanák, Jiří Vojta, and Veronika Chrenková.
    • Department of Pediatric Surgery and Trauma, University Hospital Hradec Králové, Faculty of Medicine Hradec Kralove, Charles University, Sokolska 581, 500 05, Hradec Králové, Czech Republic. radek.stichhauer@fnhk.cz.
    • Eur J Trauma Emerg Surg. 2022 Oct 1; 48 (5): 3785-3791.

    PurposeThe 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 MethodsThis 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.ResultsOf 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.ConclusionWhile 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.© 2021. Springer-Verlag GmbH Germany, part of Springer Nature.

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