Supracondylar fractures of the humerus are common and accounts for 60% of all fractures of the elbow in children. More than 95% of all supracondylar fractures are displaced in extension either in a posteromedial or posterolateral direction.1,2 Rarely anterior displacement of the distal humeral fragment results from flexion forces created by a fall directly on the olecranon.3,4 Clinical evaluation of a child with a potential supracondylar fracture includes a comprehensive history and physical examination of both the entire upper extremity and the rest of the child to rule out a concomitant injury. The mechanism
of injury should be determined. A comprehensive neurovascular examination is necessary to detect nerve
damage, vascular impairment or impending compartment syndrome.2 In the past, the incidence of true permanent sequelae of vascular injuries following displaced supracondylar fractures of the humerus was reported as rare. Because of the increased ability to recognize vascular injury, recent reports have demonstrated higher incidence of vascular injury.5 Campbell et al.6 reported that 38% of their cases had evidence of injury to brachial artery. The radial pulse is reported to be absent before reduction in 7–12% of all fractures and up to 19% in displaced fractures. After reduction, the pulse is restored in 80% of the cases.3,4,7–10 The aim of this study is to report that pulseless forearm with pink or cold hand following satisfactory closed reduction and percutaneous pinning is an indication for exploration of the brachial artery with its concomitantmedian nerve..