![]() The remaining four without a palpable pulse were managed with close observation and no deterioration of the vascular status was observed therefore, no surgical exploration was performed. ![]() All cases underwent urgent surgery, after which nine experienced immediate return of the radial pulse. Compression of the artery by the proximal fragment was observed in most cases, with one case of entrapment of the artery between fragments, and thrombus considered in two cases. Preoperative color-flow Duplex ultrasound showed no disruption of the brachial artery in cases detected. Close observation was carried out when the hand was pink and pulseless with an absent radial pulse. Urgent closed reduction and percutaneous pinning of the fractures were attempted first. Preoperative and postoperative color-flow Duplex ultrasound detection was used to assess brachial artery compromise in most cases. Thirteen consecutive children presenting with a pink pulseless hand following supracondylar humeral fracture were enrolled in this study. The present study aimed to analyze the benefits and outcomes of close observation for treating pediatric supracondylar humeral fractures with a pink pulseless hand. Some clinicians recommend close observation after closed reduction and percutaneous pinning of the fractures, while some recommend surgical exploration if the radial pulse is unpalpable. The optimal treatment for pediatric supracondylar humeral fractures accompanied with a pink pulseless hand is controversial.
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