Blunt brachial arterial injury in pediatric patients

Abstract

Blunt brachial arterial injury (BBAI) is the most common vascular injury in pediatric patients. BBAI can lead to a spectrum of clinical signs and symptoms in the affected extremity, depending on the degree of occlusion and the robustness of the collateral circulation. The proper treatment ranges from expectant and conservative medical management to surgical revascularization. Although management depends on the degree of ischemia, there remains controversy about the treatment algorithm for a pink pulseless hand after BBAI. Treatment of these pediatric vascular injuries often varies depending on the specialty of the surgeon involved. This article reviews the current literature to summarize the pathophysiology, clinical presentation, diagnosis, evaluation, and best management for BBAI injury.

Keywords: Blunt brachial artery injury; Brachial artery repair; Pediatric trauma; Pediatric vascular injury; Pediatric vascular trauma; Supracondylar subluxation; Upper extremity fracture.