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Pediatrik Suprakondiler Humerus Fraktür Redüksiyonun Çok Nadir ve Ciddi Bir Komplikasyonu: Nabızsız Üst Ekstremite ve Cerrahi Tedavisi

Year 2019, Volume: 21 Issue: 3, 257 - 259, 30.12.2019
https://doi.org/10.18678/dtfd.554740

Abstract

Suprakondiler humerus fraktürü gelişen pediatrik olgularda oluşabilecek ciddi komplikasyonlardan biri kapalı redüksiyon sonrası oluşabilecek vasküler yaralanmalardır. Ekstremite kaybı gibi ciddi komplikasyonlara neden olabilecek olduğundan, bu durum üzerinde durulması gereken önemli bir konudur. Redüksiyon sonrası nabız yetersizliği durumunda konservatif ve cerrahi yaklaşım açısından farklı görüşler vardır. Ekstremitede soğukluk, solukluk ve nabız yetmezliği gibi cerrahi müdahale gerektiren durumlar varsa, hasarlı damar segmentinin onarımının yetersiz olabileceği, traksiyon nedeniyle oluşabilecek olan endotel hasarını ortadan kaldırmak için tüm hasarlı damar segmentinin değiştirilmesi gerekebileceği akılda tutulmalıdır. Bu olgu sunumunda, suprakondiler humerus kırığı sonrası radial ve ulnar nabzı olmayan 5 yaşındaki bir çocukta iyatrojenik brakiyal arter hasarına cerrahi yaklaşım sunulmaktadır.

References

  • Dabis J, Daly K, Gelfer Y. Supracondylar fractures of the humerus in children: Review of management and controversies. Orthop Muscular Syst. 2016;5(1):206.
  • Mohammadzadeh MA, Mohammadzadeh M, Mohammadzadeh A, Herfatkar R, Mohammadzadeh V, Baghi I, et al. Arterial damage accompanying supracondylar fractures of the humerus. Trauma Mon. 2012;16(4):160-3.
  • Usman R, Jamil M, Hashmi JS. Management of arterial injury in children with supracondylar fracture of the humerus and a pulseless hand. Ann Vasc Dis. 2017;10(4):402-6.
  • Leiblein M, Lustenberger T, Schulz AK, Schmitz-Rixen T, Marzi I. Neurovascular complications after supracondylar humerus fractures in children. Trauma Case Rep. 2017;8:16-9.
  • Korompilias AV, Lykissas MG, Mitsionis GI, Kontogeorgakos VA, Manoudis G, Beris AE. Treatment of pink pulseless hand following supracondylar fractures of the humerus in children. Int Orthop. 2009;33(1):237-41.
  • Başbuğ HS, Göçer H, Özışık K. Surgical treatment of pulseless pediatric supracondylar humerus fracture. Int J Cardiovasc Acad. 2017;3(1-2):31-3.
  • Karaca OG, Mavioğlu İ, Akbaş MH, Koç A, Karaduman ZO, Kunt A. Multidisciplinary approach in "pat pat" injuries: the role of vascular surgeon. Turk J Vasc Surg. 2019;28(1):46-50.
  • Sabharwal S, Tredwell SJ, Beauchamp RD, Mackenzie WG, Jakubec DM, Cairns R, et al. Management of pulseless pink hand in pediatric supracondylar fractures of humerus. J Pediatr Orthop. 1997;17(3):303-10.

A Very Rare and Serious Complication of Pediatric Supracondylar Humerus Fracture Reduction: Pulseless Upper Extremity and Surgical Treatment

Year 2019, Volume: 21 Issue: 3, 257 - 259, 30.12.2019
https://doi.org/10.18678/dtfd.554740

Abstract

In pediatric cases with supracondylar humerus fractures, one of the serious complications that may occur after closed reduction is vascular injuries. Since it can cause serious complications like extremity loss, is an important issue to be considered. There are different opinions in terms of conservative and surgical approach in the event of a pulse failure after reduction. It should be kept in mind that if there are conditions requiring surgical intervention such as coldness, paleness and pulse failure in the extremity, the repair of the damaged vessel segment may be insufficient and it may be necessary to change the entire damaged vessel segment to eliminate endothelial damage caused by traction. In this case report, a surgical approach to iatrogenic brachial artery injury is presented in a 5 years old child who has no radial and ulnar pulse after supracondylar humerus fracture.

References

  • Dabis J, Daly K, Gelfer Y. Supracondylar fractures of the humerus in children: Review of management and controversies. Orthop Muscular Syst. 2016;5(1):206.
  • Mohammadzadeh MA, Mohammadzadeh M, Mohammadzadeh A, Herfatkar R, Mohammadzadeh V, Baghi I, et al. Arterial damage accompanying supracondylar fractures of the humerus. Trauma Mon. 2012;16(4):160-3.
  • Usman R, Jamil M, Hashmi JS. Management of arterial injury in children with supracondylar fracture of the humerus and a pulseless hand. Ann Vasc Dis. 2017;10(4):402-6.
  • Leiblein M, Lustenberger T, Schulz AK, Schmitz-Rixen T, Marzi I. Neurovascular complications after supracondylar humerus fractures in children. Trauma Case Rep. 2017;8:16-9.
  • Korompilias AV, Lykissas MG, Mitsionis GI, Kontogeorgakos VA, Manoudis G, Beris AE. Treatment of pink pulseless hand following supracondylar fractures of the humerus in children. Int Orthop. 2009;33(1):237-41.
  • Başbuğ HS, Göçer H, Özışık K. Surgical treatment of pulseless pediatric supracondylar humerus fracture. Int J Cardiovasc Acad. 2017;3(1-2):31-3.
  • Karaca OG, Mavioğlu İ, Akbaş MH, Koç A, Karaduman ZO, Kunt A. Multidisciplinary approach in "pat pat" injuries: the role of vascular surgeon. Turk J Vasc Surg. 2019;28(1):46-50.
  • Sabharwal S, Tredwell SJ, Beauchamp RD, Mackenzie WG, Jakubec DM, Cairns R, et al. Management of pulseless pink hand in pediatric supracondylar fractures of humerus. J Pediatr Orthop. 1997;17(3):303-10.
There are 8 citations in total.

Details

Primary Language English
Subjects Clinical Sciences
Journal Section Case Report
Authors

Hakan Kartal This is me 0000-0003-4539-0228

Hüseyin Sicim 0000-0003-3430-3862

Salih Güler This is me 0000-0002-6180-901X

Publication Date December 30, 2019
Submission Date April 17, 2019
Published in Issue Year 2019 Volume: 21 Issue: 3

Cite

APA Kartal, H., Sicim, H., & Güler, S. (2019). A Very Rare and Serious Complication of Pediatric Supracondylar Humerus Fracture Reduction: Pulseless Upper Extremity and Surgical Treatment. Duzce Medical Journal, 21(3), 257-259. https://doi.org/10.18678/dtfd.554740
AMA Kartal H, Sicim H, Güler S. A Very Rare and Serious Complication of Pediatric Supracondylar Humerus Fracture Reduction: Pulseless Upper Extremity and Surgical Treatment. Duzce Med J. December 2019;21(3):257-259. doi:10.18678/dtfd.554740
Chicago Kartal, Hakan, Hüseyin Sicim, and Salih Güler. “A Very Rare and Serious Complication of Pediatric Supracondylar Humerus Fracture Reduction: Pulseless Upper Extremity and Surgical Treatment”. Duzce Medical Journal 21, no. 3 (December 2019): 257-59. https://doi.org/10.18678/dtfd.554740.
EndNote Kartal H, Sicim H, Güler S (December 1, 2019) A Very Rare and Serious Complication of Pediatric Supracondylar Humerus Fracture Reduction: Pulseless Upper Extremity and Surgical Treatment. Duzce Medical Journal 21 3 257–259.
IEEE H. Kartal, H. Sicim, and S. Güler, “A Very Rare and Serious Complication of Pediatric Supracondylar Humerus Fracture Reduction: Pulseless Upper Extremity and Surgical Treatment”, Duzce Med J, vol. 21, no. 3, pp. 257–259, 2019, doi: 10.18678/dtfd.554740.
ISNAD Kartal, Hakan et al. “A Very Rare and Serious Complication of Pediatric Supracondylar Humerus Fracture Reduction: Pulseless Upper Extremity and Surgical Treatment”. Duzce Medical Journal 21/3 (December 2019), 257-259. https://doi.org/10.18678/dtfd.554740.
JAMA Kartal H, Sicim H, Güler S. A Very Rare and Serious Complication of Pediatric Supracondylar Humerus Fracture Reduction: Pulseless Upper Extremity and Surgical Treatment. Duzce Med J. 2019;21:257–259.
MLA Kartal, Hakan et al. “A Very Rare and Serious Complication of Pediatric Supracondylar Humerus Fracture Reduction: Pulseless Upper Extremity and Surgical Treatment”. Duzce Medical Journal, vol. 21, no. 3, 2019, pp. 257-9, doi:10.18678/dtfd.554740.
Vancouver Kartal H, Sicim H, Güler S. A Very Rare and Serious Complication of Pediatric Supracondylar Humerus Fracture Reduction: Pulseless Upper Extremity and Surgical Treatment. Duzce Med J. 2019;21(3):257-9.