title: Delayed presentation of a brachial artery pseudoaneurysm after a supracondylar humerus fracture in a 6-year-old boy: a case report.
abstract: Supracondylar fractures of the humerus are the most common elbow fractures in children, accounting for 60% to 70% of all pediatric elbow fractures. These fractures often have neurovascular complications because of deformity and the sharp nature of the fracture fragments. The management of patients who present with diminished or absent pulses, but a well-perfused extremity is a topic of debate. Between 3% and 14% of patients present with an altered vascular examination and a consistent treatment logarithm has not been proposed in the literature. To our knowledge, a brachial artery pseudoaneurysm presenting in a delayed fashion in the setting of a normal vascular examination has not been reported. We report a 6-year-old boy who had a delayed presentation of a brachial artery pseudoaneurysm after a supracondylar humerus fracture, which was repaired with a saphenous vein graft. This is to emphasize close neurological and vascular monitoring even in the setting of a well-perfused hand. In addition, this would suggest that closer postoperative evaluation in significantly displaced fractures should be performed, even beyond the fracture healing stage.
authors.affiliation: Division of Orthopaedic Surgery and Vascular Surgery, Warren Alpert Medical School at Brown University, 593 Eddy Street, Providence, RI 02903, USA. cgotmd@gmail.com
authors.forename: Christopher
authors.initials: C
authors.lastname: Got
authors.forename: Tze-Woei
authors.initials: TW
authors.lastname: Tan
authors.forename: Nikhil
authors.initials: N
authors.lastname: Thakur
authors.forename: Edward J
authors.initials: EJ
authors.lastname: Marcaccio
authors.forename: Craig
authors.initials: C
authors.lastname: Eberson
authors.forename: Ian
authors.initials: I
authors.lastname: Madom
mesh_terms: D017541:Aneurysm, False / Q000175:diagnosis / Q000209:etiology*; D001916:Brachial Artery / Q000293:injuries*; D002648:Child; D005500:Follow-Up Studies; D005593:Fracture Fixation, Internal / Q000379:methods; D017102:Fracture Healing; D006801:Humans; D006810:Humeral Fractures / Q000150:complications* / Q000601:surgery; D008297:Male; D012501:Saphenous Vein / Q000637:transplantation; D013997:Time Factors