ABSTRACT
This chapter presents a case study of a 45-year-old man who is brought in to the Emergency Department resuscitation room as a trauma call. This man has a complex supracondylar fracture of the humerus with vascular compromise. Supracondylar fractures in the adult are relatively uncommon but are seen in major trauma or in elderly patients where bone quality may be compromised. Elbow fractures need careful neurovascular evaluation as well as examination of shoulder and wrist joints. In this case, the patient has a cool and mottled hand, which strongly suggests a vascular injury. The junior doctors should try and palpate the distal wrist pulses and call for immediate vascular and orthopaedic help. In the Emergency Department, gently flexing or extending the elbow by as little as 15 degrees may result in reperfusion of the hand. The patient will need to be transferred to theatre for open reduction and internal fixation of the fracture and repair of any vascular structures.
