Brachial artery disruption following closed posterior elbow dislocation in a child--assessment with intravenous digital angiography. A case report with review of the literature.

An 11-year-old boy sustained complete brachial artery disruption following closed posterior elbow dislocation. This is the first documentation in the English-language literature of this type of arterial transection following closed elbow dislocation in a child. It is also the first report of surgical repair of the brachial artery following elbow dislocation in a child. The patient's radial pulse was absent the day following the injury, and on Doppler examination blood flow was audible over the radial artery. Hand perfusion, however, remained excellent. Intravenous digital angiography demonstrated complete disruption of the brachial artery. This procedure is relatively painless compared with conventional angiography with percutaneous arterial puncture. The procedure provides the treating physician with an objective method for assessing brachial artery integrity. Arterial repair may decrease the potential risks of delayed complications, e.g., cold intolerance, potential growth disturbance, and possible delayed neurovascular residues associated with localized ischemia to the forearm and hand.