Management of Supracondylar Fracture:  With Vascular Insufficiency

Arch Surg. 1965;90(2):279-285. doi:10.1001/archsurg.1965.01320080103022.
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Introduction  ACUTE VASCULAR insufficiency of the forearm and hand is an uncommon and possibly tragic complication of supracondylar fracture of the humerus in children. Marked posterior displacement of the distal fragment of the humerus in such injuries leads to rupture of the brachialis muscle and compression of the brachial artery by the anterior edge of the proximal fragment of the humerus. A prompt return of color and warmth to the hand follows closed reduction of the fracture in the great majority of instances. In the rare case, operative exploration of the fracture may be necessary to restore an adequate circulation to the distal limb. Failure to relieve the vascular insufficiency leads to the Volkman's syndrome with varying amounts of muscle and nerve damage.The information that is available on the operative management of such injuries is limited to three reports. In 1955 Lipscomb and Burleson 5 briefly described their experiences


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