Pulseless Pink Hand Syndrome: Methods and Flow Charts of the Motor, Sensory and Vascular Examination

Supracondylar humerus fracture is one of the most common elbow injuries in children, comprising 60% of all the elbow injuries in children. An elbow or forearm fracture should be suspected in a child with elbow pain or failure to use the upper extremity after a fall. The fracture typically occurs through the weak metaphyseal bone proximal to the fossae. A careful examination of the entire arm should be performed, and any area with tenderness or swelling should have radiograph as multiple fracture (such as supracondylar fracture and a radius/ulna fracture) are not uncommon. A thorough motor, sensory and vascular examinations should be performed, difficult in pediatric group but should be attempted and recorded accurately. Assessment of vascular status in supracondylar fracture of humerus is important as up to 20% of displaced fractures present with vascular compromise. Here we present a case report of 7-year-old girl who sustained extension type supracondylar humerus fracture with pulseless pink hand. Urgent manipulation was undertaken but it was unsuccessful, a posterior stab incision was taken to reduce the fracture fragments using bone spike. To our knowledge, there are various methods and flow charts regarding the treatment of the vascular compromise which accompany various associated risks and complications with no specific protocol