Figure 90.1 Position of pulse points Figure 90.2 Pain assessment
90
Neurovascular observations
For any child or young person who has traction or a cast applied following acute injury or orthopaedic surgery it is essential that neurovascular observations are monitored and recorded to assess the risk of developing complication of recovery (GOSH 2011).
Compartment syndrome, neurovascular deficit and vascular impairment are rare complications of injury and surgery that, if not detected early or left untreated, may result in disability or death of the child or young person (Wright 2009; GOSH 2011). Compartment syndrome usually becomes apparent in the first 72 hours after injury or surgery but may be as soon as 48 hours or as late as 6 days (GOSH 2011). Although there is evidence to suggest that in children it may occur 8 hours after injury (Ferlic et al. 2012).
Compartment syndrome
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