Cenk Ermutlu, Bartu Sarısözen, Kemal Durak, Teoman Atıcı, Adnan Çakar

Department of Orthopedics and Traumatology, Uludağ University Faculty of Medicine, Bursa, Türkiye

Keywords: Antecubital approach, brachial artery, pulseless, supracondylar humerus fracture.


Management of pediatric pulseless supracondylar humerus fractures is a point of continuous debate. In this article, we present three cases admitted to the emergency department with pulseless, but well-perfused hands. The fractures were reduced and fixed using the antecubital approach. Prior to reduction, the brachial arteries of all three patients were entrapped in the cancellous bone of the proximal fragment segment. The arteries could only be released after freeing the adventitia by carefully scraping the adjacent bone with the tip of a hemostat. One case required thrombectomy through an arteriotomy using No. 3 Fogarty catheter. In two cases, the pulse returned after a brief period of waiting with no need for vascular intervention. Proceeding with closed reduction, as proposed by the recent guidelines, would result in further damage to the entrapped vasculature, which may go unnoticed due to collateral circulation.

Citation: Ermutlu C, Sarısözen B, Durak K, Atıcı T, Çakar A. Entrapment of the brachial artery in the cancellous bone in pulseless supracondylar humerus fractures with well-perfused hands: Report of three cases. Jt Dis Relat Surg 2022;33(3):680-685.

Author Contributions

Idea/concept, design, literature review, writing the article: C.E.; Idea/concept, design, writing the article, literature review: K.S.; Idea/concept, design, critical review, control: K.D., T.A.; Idea/concept, design, data collection, writing the article: A.Ç.

Conflict of Interest

The authors declared no conflicts of interest with respect to the authorship and/or publication of this article.

Financial Disclosure

The authors received no financial support for the research and/or authorship of this article.