A five-year-old boy was admitted with a supracondylar fracture of the distal humerus. After the closed reduction, the hand was pink, but
persistent absence of radial pulse was revealed. Pulse oximetry detected flattened waveform compared to the unaffected limb. Doppler
ultrasound examination suggested distal brachial artery occlusion. During operation, artery dissection was found, the injured segment was
resected, and the vessel was repaired in an end-to-end fashion. In conclusion, pulse oximetry with waveform analysis is a valuable method
for screening of brachial artery injuries in children with a pink pulseless hand.
Key words: Brachial artery, humeral fractures, photoplethysmography, vascular injuries
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