MANAGEMENT OF PULSELESS HAND IN CHILDREN FOLLOWING CLOSED SUPRACONDYLAR FRACTURE HUMERUS - BEFORE FRACTURE REDUCTION A CASE SERIES.
Journal Title: International Journal of Advanced Research (IJAR) - Year 2018, Vol 6, Issue 7
Abstract
Closed supracondylar humerus fracture in children with pulseless hand though appear to have vascularity even after skeletal stabilisation may need surgical exploration for addressing vascular injury which is often accomplished by thrombectomy , primary repair or interposition graft repair. Between August 2017 and june 2018, 15 children presented with displaced closed supracondylar fracture of the humerus , 10 of them presented with absent radial and ulnar pulses treated either before or after fracture reduction based on the clinical examination findings and hand doppler assessment . Amongst these, seven patients were explored for vascular compromise even after fracture reduction and ended up in revascularisation by thrombectomy or interposition graft repair . Three patients were explored before fracture reduction , one was found to have entrapment of the brachial artery between the fracture fragments and two of them were found to have spasm of the brachial artery by the tractional force from the displaced fracture. surgical exploration before fracture reduction in all these three patients ended up in release of the brachial artery from the tractional force or from entrapped fracture fragment, resulted in distal pulse restoration and thereby avoided thrombectomy or graft repair in the growing children. children presenting with closed supracondylar humerus fracture with absent distal pulses with warm hand need high index of suspicion for exploration before fracture reduction to avoid fracture reduction manipulation associated vascular injury and thereby avoid thrombectomy and graft repair in the growing children.
Authors and Affiliations
M. Krishna MS MCh, Jayanth. V. Kumar MS MCh, N. Sritharan MS MCh, I. Devarajan MS , MC
Keywords
Related Articles
- EP ID EP366449
- DOI 10.21474/IJAR01/7399
- Views 57
- Downloads 0
PREGNANCY AFTER ENTEROCYSTOPLASTY: A CASE REPORT.
Pregnancy after enterocystoplasty remains a rare case, only few cases have been reported. It involves particular risks during pregnancy and also during delivery, hence the need for multidisciplinary obstetric and urologi...
AN AYURVEDIC MANAGEMENT OF AMLAPITTA A REVIEW.
Modern era\'s changing life style along with changing food culture and depending upon one?s body constitution Amlapitta is one of the most common disease. The stomach normally secrets acid that is essential in the digest...
ANTITHYMOCYTE GLOBULIN, METHYLPREDNISOLONE AND CYCLOSPORINE IS AN EFFECTIVE TREATMENT IN SEVER APLASTIC ANEMIA.
Background: Immune suppressive therapy in severe aplastic anemia is considered now a standard treatment and it could be an alternative to the hemopoietic stem cell transplantation. Patients and methods: Thirteen Iraqi pa...
HOUSING AND MIGRATION: MARGINALISING THE MARGINALISED.
Migration in India has been a historical process which has re emerged as a strong force shaping cities and urbanisation. Urban poor and migration are closely interrelated. This paper reflects on the linkages of urban poo...
IN VITRO EVALUATION OF ANTI FUNGAL ACTIVITY OF SOME MEDICINAL PLANTS AGAINST HELMINTHOSPORIUM ORYZAE, THE INCITANT OF BROWN SPOT DISEASE OF PADDY.
Brown spot of rice incited by Helminthosporium oryzae is a serious disease and cause considerable yield loss. Several fungicides have been reported to control the disease effectively. With the increase in awareness on th...