Cunha Luiz Antônio Munhoz da, Ávila Luiz Muller, Gonçalves João Rodolfo Radtke, Pereira Suelin, Jamur Carmen Mayanna, Souza Bruna Medeiros de
Department of Surgery, Universidade Federal do Paraná (UFPR).
Orthopedic Departament, Children's Hospital Pequeno Príncipe, Curitiba, Paraná, Brazil.
J Pediatr Orthop B. 2019 Nov;28(6):559-563. doi: 10.1097/BPB.0000000000000647.
The supracondylar humerus fracture is the most common elbow fracture in children, corresponding to 58% of these cases. The objective of this study is to report a rare postoperative complication, the pseudoaneurysm of the brachial artery. A 9-year-old girl with was admitted with a Gartland III supracondylar fracture of the right humerus, presenting normal neurological and vascular exams. The patient underwent a surgical treatment with percutaneous fixation and immobilization and was re-evaluated after 2 and 4 weeks. In the last evaluation the immobilization and fixation were removed. She returned after 3 months, presenting a progressive palpable, painless mass in the 1/3 distal right arm. The arterial ultrasound showed a mass in the cubital fossa, which presented internal flow and some wall thrombi, compatible with pseudoaneurysm of the brachial artery. After diagnosis, the treatment was a vascular surgery for dissection and reconstruction of the artery. The incidence of vascular involvement in Gartland III fractures ranges from 2% to 38%. False aneurysms originate from arterial hematomas caused by trauma to the arterial lumen, and their developing time can vary. There are few reports of this complication, so there is no consensus about the treatment.
肱骨髁上骨折是儿童最常见的肘部骨折，占此类病例的58%。本研究的目的是报告一种罕见的术后并发症——肱动脉假性动脉瘤。一名9岁女孩因右肱骨Gartland III型髁上骨折入院，神经和血管检查均正常。患者接受了经皮固定和制动的手术治疗，并在2周和4周后进行了复查。在最后一次评估时，去除了固定装置。3个月后她再次前来就诊，右上肢远端1/3处出现一个可逐渐触及的无痛肿块。动脉超声显示肘窝处有一个肿块，有内部血流和一些壁血栓，符合肱动脉假性动脉瘤。诊断后，治疗方法是进行血管手术，对动脉进行解剖和重建。Gartland III型骨折中血管受累的发生率为2%至38%。假性动脉瘤起源于动脉腔创伤引起的动脉血肿，其发展时间可能不同。关于这种并发症的报道很少，因此在治疗方面没有共识。
