PURPOSE: The appropriate treatment of pulseless pink supracondylar humerus fractures (SCHF) remains controversial. In this study, the outcomes of two treatment approaches (with and without vascular surgery) were compared. MATERIAL AND METHODS: This was a retrospective multicenter study of patients with pulseless pink SCHFs treated in ten pediatric surgery, trauma, or orthopedics departments in the Czech and Slovak Republic between 2014 and 2018. RESULTS: Of the total 3608 cases of displaced SCHF, 125 had the pulseless pink SCHF. Of those, 91% (114/125) did not undergo vascular surgery and 9% (11/125) underwent vascular surgery. The patients who did undergo vascular surgery had radial artery pulsation restored more frequently in the operating room (73% vs. 36%; p = 0.02), within 6 h (91% vs. 45%; p = 0.004), and within 24 h of surgery (91% vs. 57%; p = 0.05). However, 72 h after surgery, there was no significant difference in palpable radial artery pulsation between the vascular surgery and the non-vascular surgery groups (91% vs. 74%; p = 0.24). Additionally, no significant differences in long-term neurological (9% vs. 22%; p = 0.46) or circulatory (9% vs. 7%; p = 0.57) deficits were found between the two groups. CONCLUSION: While vascular surgery in patients with pulseless pink SCHFs is associated with a more prompt restoration of radial artery pulsation, no statistical significant differences in terms of the restoration of neurological deficits or the risks of long-term neurological or circulatory deficits were found between patients with and without vascular surgery.

Clinic of Orthopedics and Trauma University Hospital Pilsen E Beneše 1128 30100 Pilsen Czech Republic

Clinic of Pediatric Orthopedics and Trauma 2nd Faculty of Medicine Charles University Prague and Motol University Hospital 5 Úvalu 84 15006 Prague Czech Republic

Clinic of Pediatric Surgery Orthopedics and Trauma University Hospital Faculty of Medicine Masaryk University Černopolní 9 61300 Brno Czech Republic

Department of Pediatric Surgery and Trauma Hospital Ústí nad Labem Sociální péče 3316 12A 40113 Ústí nad Labem Czech Republic

Department of Pediatric Surgery and Trauma University Hospital Bulovka Budínova 2 18000 Prague Czech Republic

Department of Pediatric Surgery and Trauma University Hospital Hradec Králové Faculty of Medicine Hradec Kralove Charles University Sokolska 581 500 05 Hradec Králové Czech Republic

Department of Pediatric Surgery Hospital Pardubice Kyjevská 44 53003 Pardubice Czech Republic

Department of Trauma Surgery Hospital České Budějovice B Němcové 585 54 37001 České Budějovice Czech Republic

Pediatric Surgery Department National Institute of Children´s Diseases and Faculty of Medicine Comenius University Limbová 1 83340 Bratislava Slovak Republic

Trauma Clinic University Hospital Ostrava 17 listopadu 1790 5 70800 Ostrava Czech Republic

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