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학습 자료 둘러보기 →A pulseless extremity after a supracondylar humerus fracture is a vascular emergency. The brachial artery runs close to the fracture site and can be compressed, go into spasm, or be lacerated. This takes absolute priority over pain, swelling, or guarding.
Assess for the pink, pulseless hand (PPH). The hand may appear warm with normal capillary refill despite an absent radial pulse due to collateral circulation. Do not be falsely reassured by a well-perfused hand; the absence of a pulse still indicates a threatened limb.
Immediate orthopedic consultation is required. Definitive treatment is urgent closed reduction and percutaneous pinning (CRPP). Delay in restoring perfusion risks irreversible ischemic damage and Volkmann’s contracture.
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