• Christopher Got, Tze-Woei Tan, Nikhil Thakur, Edward J Marcaccio, Craig Eberson, and Ian Madom.
• Division of Orthopaedic Surgery and Vascular Surgery, Warren Alpert Medical School at Brown University, 593 Eddy Street, Providence, RI 02903, USA. cgotmd@gmail.com
• J Pediatr Orthop. 2010 Jan 1;30(1):57-9.

AbstractSupracondylar fractures of the humerus are the most common elbow fractures in children, accounting for 60% to 70% of all pediatric elbow fractures. These fractures often have neurovascular complications because of deformity and the sharp nature of the fracture fragments. The management of patients who present with diminished or absent pulses, but a well-perfused extremity is a topic of debate. Between 3% and 14% of patients present with an altered vascular examination and a consistent treatment logarithm has not been proposed in the literature. To our knowledge, a brachial artery pseudoaneurysm presenting in a delayed fashion in the setting of a normal vascular examination has not been reported. We report a 6-year-old boy who had a delayed presentation of a brachial artery pseudoaneurysm after a supracondylar humerus fracture, which was repaired with a saphenous vein graft. This is to emphasize close neurological and vascular monitoring even in the setting of a well-perfused hand. In addition, this would suggest that closer postoperative evaluation in significantly displaced fractures should be performed, even beyond the fracture healing stage.

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