[Concurrent vascular injuries in fractures in childhood].

Ten-year-analysis of blood vessel lesions present in eleven children with bone fractures revealed two major localizations: 1. In the lower extremity we observed vascular lesions in both open and closed fractures of femur and tibia. In cases with (complete) ischemia emergency operation had to be performed. 2. In the upper extremity the prevalent fracture localization was the supracondylar fracture of the elbow. Incomplete ischemia present in fractures with severe dislocation (Felsenreich III) could be salvaged by closed reposition and transcutaneous fixation by means of Kirschner wires. In those few cases open reposition was necessary, both exposure of vessels and fixation of the fracture was possible when medial incision was performed. Postoperative evaluation of patients included angiography (DSA) and ultrasound (Doppler).