Case Report

Profunda Brachii Pseudoaneurysm following Supracondylar Fracture of Humerus Repair in an 8-Year-Old Boy: A Case Report and Review of Literature

Table 1

A review of reported cases of arterial pseudoaneurysm after supracondylar fracture of humerus fixation.

Firth authorAge (years)Interval till initial presentationInitial physical examDiagnosisType of fixationIntraoperative findings agent

Asavamongkolkul and Ruangsetakit [9]37 months(i) 4 cm mass without erythema or warmth
(ii) No pulsation, bruit on auscultation
Brachial angiographyOR via a posterior longitudinal incision and internal fixation with two-crossed K-wire.Tips of the K-wire were stuck inside the aneurysm.
Chikande et al. [10]611 days(i) Painful tumefaction of the medial and distal part of the arm
(ii) Fever
(iii) Weak radial pulse
(iv) Normal cutaneous hand perfusion
Duplex ultrasound and CT angiographyCRIF using 3 K-wire, 2 percutaneous from lateral condyle, and one by a mini-approach on medial epicondyle.Brachial artery perforation without contacts with wires.
Hernandez et al. [11]721 days(i) Medial mass of the elbow, with no palpable thrill, or audible bruit
(ii) Distal radial and ulnar pulses were present
Duplex ultrasound and CT angiographyCR and internal fixation with two lateral K-wires under fluoroscopic control.Injury may be produced by punction humeral artery during the insertion of the wires.
Cunha et al. [12]912 weeks(i) Palpable, painless, and pulsatile mass
(ii) Distal pulses were symmetric and palpable
Duplex ultrasoundPercutaneously using three K-wire placed divergently in a lateral-to-medial position.Bone spicula perforating the artery during trauma or the maneuver reduction.
Got et al. [13]65 weeks(i) Diminished sensation and strength in the radial nerve distribution
(ii) Diminished radial pulse
(iii) Continued swelling in the antecubital fossa
Soft tissue sonography.CR and percutaneous pin fixation of the supracondylar fracture with 3 lateral K-wire.The pseudoaneurysm was a 1 cm segment of the posterolateral wall of the brachial artery.
Tepper et al. [4]922 days(i) Elbow mass, tender to palpation, and no pulsatile quality
(ii) No overt palpable thrill
(iii) Normal neurovascular examination
Intraoperative diagnosis was done during hematoma evacuation.CR and percutaneous pin fixation with 2 K-wire inserted from the lateral condyle and divergent across the fracture site.Ruptured left brachial artery pseudoaneurysm and a complex longitudinal arterial tear at the fracture site. The fixation pins were not near the pseudoaneurysm and were left in place because the fixation remained stable.
Bhandari et al. [14]13 years old2 weeks(i) An expansile swelling of 5 cm diameter with thrill with normal radial pulseCR and k-wire fixation (4 K-wire)Brachial artery pseudoaneurysm

CR: closed reduction; CRIF: closed reduction and internal fixation; CT: computed tomography; OR: open reduction; K-wires: Kirschner wires.