Non-palpable pulse distal to the fracture

Mechanisms

1. Kinking
2. Dissection
3. Direct vessel injury

Risk Factors

• !High-Impact Trauma (and other consequences it is associated with)
• Anatomical Position: Proximal humor fracture → Brachial artery

Management

1. Confirm that this is a true vascular injury by Doppler US

   • DDX:

2. 2 Plane XR + Angiogram (conventional or CT)

   

   

3. If Gross Displacement exist, conduct Emergency Closed Reduction Protocol

4. OPIF - Open Reduction Internal Fixation within 6 hr

   • Limb threatening after 6 hr
   • Life threatening blood loss (BL CBC and Hb (110-115) should have been obtained upon admission)