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AAOS issues new clinical practice guideline for treating common elbow fractures in children
Date:11/16/2011

t a pulse is to gently realign the arm. Once the fracture is put back into the proper position and established, circulation will likely recover.

  • However, sometimes there is still no pulse in the arm following realignment. This can occur with or without adequate blood flow. The guideline recommends the surgical "exploration" of the blood vessels and nerves in front of the elbow in patients with no wrist pulse, if the hand remains cold and underperfused (without adequate blood flow), to "ensure survival of the tissues in the arm and hand." In these rare instances, further surgery may be necessary "to prevent rare, but serious, limb threatening and life threatening consequences," according to the guideline.

    The guideline states: "If the hand feels warm, has color from circulation that you can see, and the child can move the muscles of the forearm and demonstrate some motion, then there is evidence that tissues are being nourished despite the absent pulse." The guideline does not specifically recommend surgery or observation in these cases.

    "Ultimately, each physician must evaluate his or her patient's condition and circumstance and figure out 'how do I best treat this child," added Dr. Howard.


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  • Contact: Lauren Pearson
    pearson@aaos.org
    847-384-4031
    American Academy of Orthopaedic Surgeons
    Source:Eurekalert

    Page: 1 2

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