Pink pulseless hand following supra-condylar fractures: an audit of British practice

A postal questionnaire was sent to the members of the British Society for Children's Orthopaedic Surgery to form a consensus on the management of displaced supra-condylar fractures especially when complicated by a 'pink pulseless hand'. A majority of the paediatric orthopaedic practitioners in the United Kingdom would deal with the uncomplicated supra-condylar fractures as soon as possible but not after midnight. In the absence of a radial pulse, stabilization would be considered even after midnight. If the hand remains pulseless but well perfused after stabilization the preferred option would be to observe and rely on collateral circulation rather than treating it more aggressively.