Arm ischemia in a 4-year-old boy with supracondylar fracture of the humerus due to constraining bands over the brachial artery

Supracondylar humerus fractures are common in children and can compromise the brachial artery in 5% to 15% of cases. A 4-year-old boy with a left supracondylar fracture developed upper extremity ischemia after pinning of the fracture. Computed tomography angiography revealed cutoff of flow in the brachial artery. Intraoperatively, he was found to have bands tethering the artery into the fracture, obstructing the blood flow. The orthopedic pins were removed, and the constraining bands were lysed to free the artery, with reconstitution of flow confirmed by intraoperative angiography. The fracture was reduced and stabilized, and the patient recovered well with normal arterial flow on follow-up ultrasound after 3 months.