• Emin Özkul, Mehmet Gem, Celil Alemdar, Hüseyin Arslan, İbrahim Azboy, and Velat Çelik.
• Dicle University Faculty of Medicine, Department of Orthopaedics and Traumatology, Diyarbakır, Turkey. eminozkul21@hotmail.com.
• Ulus Travma Acil Cer. 2016 Jan 1; 22 (1): 84-9.

BackgroundThe aim of this study was to evaluate the outcomes of the children with absent distal pulses following supracondylar humerus fractures.MethodsForty-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.ResultsIn 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.DiscussionIt 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.

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