{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,6,25]],"date-time":"2026-06-25T04:13:27Z","timestamp":1782360807373,"version":"3.54.5"},"reference-count":28,"publisher":"British Editorial Society of Bone & Joint Surgery","issue":"11","license":[{"start":{"date-parts":[[2009,11,1]],"date-time":"2009-11-01T00:00:00Z","timestamp":1257033600000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/online.boneandjoint.org.uk\/TDM"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["The Journal of Bone and Joint Surgery. British volume"],"published-print":{"date-parts":[[2009,11]]},"abstract":"<jats:p> A series of 26 children was referred to our specialist unit with a \u2018pink pulseless hand\u2019 following a supracondylar fracture of the distal humerus after a mean period of three months (4 days to 12 months) except for one referred after almost three years. They were followed up for a mean of 15.5 years (4 to 26). The neurovascular injuries and resulting impairment in function and salvage procedures were recorded. The mean age at presentation was 8.6 years (2 to 12). There were eight girls and 18 boys. <\/jats:p><jats:p> Only four of the 26 patients had undergone immediate surgical exploration before referral and three of these four had a satisfactory outcome. In one child the brachial artery had been explored unsuccessfully at 48 hours. As a result 23 of the 26 children presented with established ischaemic contracture of the forearm and hand. Two responded to conservative stretching. In the remaining 21 the antecubital fossa was explored. The aim of surgery was to try to improve the function of the hand and forearm, to assess nerve, vessel and muscle damage, to relieve entrapment and to minimise future disturbance of growth. <\/jats:p><jats:p> Based on our results we recommend urgent exploration of the vessels and nerves in a child with a \u2018pink pulseless hand\u2019, not relieved by reduction of a supracondylar fracture of the distal humerus and presenting with persistent and increasing pain suggestive of a deepening nerve lesion and critical ischaemia. <\/jats:p>","DOI":"10.1302\/0301-620x.91b11.22170","type":"journal-article","created":{"date-parts":[[2009,10,31]],"date-time":"2009-10-31T21:17:52Z","timestamp":1257023872000},"page":"1487-1492","source":"Crossref","is-referenced-by-count":80,"title":["Ischaemia and the pink, pulseless hand complicating supracondylar fractures of the humerus in childhood"],"prefix":"10.1302","volume":"91-B","author":[{"given":"C. M.","family":"Blakey","sequence":"first","affiliation":[{"name":"Research and Education, South West London Elective Orthopaedic Centre, Dorking Road, Epsom KT18 7EG, UK."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"L. C.","family":"Biant","sequence":"additional","affiliation":[{"name":"The Royal Infirmary of Edinburgh, 51 Little France Crescent, Old Dalkeith Road, Edinburgh EH16 4SA, UK."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"R.","family":"Birch","sequence":"additional","affiliation":[{"name":"The Peripheral Nerve Injury Unit, The Royal National Orthopaedic Hospital, Brockley Hill, Stanmore, Middlesex HA7 4LP, UK."}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"42","reference":[{"key":"R1","unstructured":"Eastcott HHG, Rose GA. Causes and mechanisms of arterial disease. In: Eastcott HGG, ed. Arterial surgery. Third ed. Edinburgh; Churchill Livingstone, 1992:32\u20135."},{"key":"R2","unstructured":"Wilkins KE. Fractures and dislocations of the elbow region. In: Rockwood CA, Wilkins KE, King RE, eds. Fractures in children. Third ed. Philadelphia: JB Lippincott, 1984:540\u20131."},{"key":"R3","doi-asserted-by":"publisher","DOI":"10.1016\/S0363-5023(05)80046-2"},{"key":"R4","doi-asserted-by":"publisher","DOI":"10.1302\/0301-620X.90B9.20728"},{"key":"R5","doi-asserted-by":"crossref","unstructured":"Liscomb PR. Vascular and neural complications in supracondylar fractures of the humerus in children. J Bone Joint Surg [Am] 1955;37-A:487\u201392.","DOI":"10.2106\/00004623-195537030-00004"},{"key":"R6","doi-asserted-by":"publisher","DOI":"10.1097\/00005131-199608000-00008"},{"key":"R7","doi-asserted-by":"publisher","DOI":"10.1097\/01.bpb.0000236236.49646.03"},{"key":"R8","doi-asserted-by":"publisher","DOI":"10.1097\/01241398-199501000-00011"},{"key":"R9","doi-asserted-by":"publisher","DOI":"10.1016\/S0020-1383(02)00312-1"},{"key":"R10","doi-asserted-by":"publisher","DOI":"10.1097\/01241398-199609000-00009"},{"key":"R11","doi-asserted-by":"publisher","DOI":"10.1097\/01202412-200601000-00011"},{"key":"R12","doi-asserted-by":"crossref","unstructured":"Omid R, Choi PD, Skaggs MD. Supracondylar humeral fractures in children: current concepts review. J Bone Joint Surg [Am] 2008;90-A:1121\u201332.","DOI":"10.2106\/JBJS.G.01354"},{"key":"R13","doi-asserted-by":"publisher","DOI":"10.1302\/0301-620X.73B1.1991753"},{"key":"R14","unstructured":"Birch R, Bonney G, Wynn Parry C, eds. Surgical disorders of the peripheral nerves. First ed. Edinburgh: Churchill Livingstone, 1998:47\u20138."},{"key":"R15","doi-asserted-by":"publisher","DOI":"10.1016\/j.jhsa.2006.11.008"},{"key":"R16","doi-asserted-by":"publisher","DOI":"10.1097\/00003086-197511000-00003"},{"key":"R17","doi-asserted-by":"publisher","DOI":"10.1302\/0301-620X.89B10.19717"},{"key":"R18","unstructured":"Johnson D, Ellis H. Pectoral girdle and upper limb. In: Standring E, ed. Gray\u2019s anatomy: the anatomical basis of clinical practice. 39th ed. Edinburgh: Churchill Living-stone, 2004:859\u201369."},{"key":"R19","doi-asserted-by":"publisher","DOI":"10.1146\/annurev.fl.25.010193.000245"},{"key":"R20","doi-asserted-by":"publisher","DOI":"10.1111\/j.1399-5448.2006.00209.x"},{"key":"R21","doi-asserted-by":"publisher","DOI":"10.1097\/00006534-198705000-00020"},{"key":"R22","unstructured":"Lewis T, Pickering AW, Rothschild P. Centripetal paralysis arising out of arrested blood flow to the limb. Heat 1935;16:1\u201331."},{"key":"R23","unstructured":"Birch R, Bonney G, Wynn Parry C, eds. Reactions to injury. In: Surgical disorders of the peripheral nerves. First ed. Edinburgh: Churchill Livingstone, 1998:37\u201355."},{"key":"R24","doi-asserted-by":"crossref","unstructured":"D\u2019Sa AAB, Harkin DW. Pathophysiology of acute vascular insufficiency. In: D\u2019Sa A, Chant A, eds. Emergency vascular and endovascular surgical practice. Second ed. London: Saunders Ltd, 2005:17\u201327.","DOI":"10.1201\/b13193-6"},{"key":"R25","doi-asserted-by":"crossref","unstructured":"G\u00fclg\u00f6nen A. Surgery for Volkmann\u2019s ischaemic contracture. J Hand Surg [Br] 2001;26:283\u201396.","DOI":"10.1054\/jhsb.2001.0577"},{"key":"R26","doi-asserted-by":"publisher","DOI":"10.1302\/0301-620X.61B3.479250"},{"key":"R27","unstructured":"Wadsworth TG. The elbow. New York: Churchill Livingstone, 1982:226\u20138."},{"key":"R28","doi-asserted-by":"publisher","DOI":"10.1016\/0072-968X(73)90049-1"}],"container-title":["The Journal of Bone and Joint Surgery. British volume"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/online.boneandjoint.org.uk\/doi\/pdf\/10.1302\/0301-620X.91B11.22170","content-type":"application\/pdf","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/online.boneandjoint.org.uk\/doi\/full-xml\/10.1302\/0301-620X.91B11.22170","content-type":"application\/xml","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/online.boneandjoint.org.uk\/doi\/pdf\/10.1302\/0301-620X.91B11.22170","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2021,8,16]],"date-time":"2021-08-16T18:14:04Z","timestamp":1629137644000},"score":1,"resource":{"primary":{"URL":"https:\/\/online.boneandjoint.org.uk\/doi\/10.1302\/0301-620X.91B11.22170"}},"subtitle":["LONG-TERM FOLLOW-UP"],"short-title":[],"issued":{"date-parts":[[2009,11]]},"references-count":28,"journal-issue":{"issue":"11","published-print":{"date-parts":[[2009,11]]}},"alternative-id":["10.1302\/0301-620X.91B11.22170"],"URL":"https:\/\/doi.org\/10.1302\/0301-620x.91b11.22170","relation":{},"ISSN":["0301-620X","2044-5377"],"issn-type":[{"value":"0301-620X","type":"print"},{"value":"2044-5377","type":"electronic"}],"subject":[],"published":{"date-parts":[[2009,11]]}}}