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Loose-fitting splint application and reassess in 1 hour
1%
11/1706
Emergent closed reduction and pin fixation
90%
1536/1706
Angiogram
19/1706
Open vascular exploration
8%
133/1706
Forearm skeletal traction pin
0%
0/1706
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Otsuka and Kasser stated: "Vascular insufficiency at presentation (prevalence, 5%-17%) should be managed initially by rapid reduction and pinning without arteriography." Copley et al looked at 128 consecutive children with grade III supracondylar humeral fractures. 17 had absent or diminished radial pulses on initial examination. 14 of these 17 children recovered pulse (palpable) after reduction and stabilization of their fractures. The remaining three had persistent absence of radial pulse. Each of these three children were explored immediately and found to have a significant vascular injury requiring repair.
3.6
(28)
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