Abstract
Supracondylar fractures of the humerus in children are difficult injuries. Thorough assessment and documentation of the neuro-vascular condition of the arm on admission and during the treatment are needed. Radiological evaluation allows to classify the injury and to choose treatment strategy. Extension mechanism is prevailing in these injuries. Displaced fractures require closed reduction and transcutaneous wire fixation, ideally performed by the senior surgeon. During plaster cast immobilization flexion in the elbow shall be avoided as it may provoke vascular disturbances. When normal blood supply of the limb is maintained, surgical treatment may be delayed until skilled surgical team and other resources are available. In cases with the disturbances of the distal flow urgent reduction of the fracture is indicated, which allows to restore the blood supply in 80 % of cases. When after reduction the absence of pulsation on a.radialis is associated with the pink hand — surgical revision and exploration of humeral artery is indicated.
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