The purpose of this study was to describe our experience with poorly perfused hands after supracondylar fracture of the humerus (SFH) in children and to present mid-term outcomes of a single trauma center. This is a retrospective analysis of SFH patients with vascular injuries, conducted from 2003 to 2012. Nine patients (2.1% of all SFH patients) underwent vascular reconstruction with no hand perfusion after adequate reduction and fixation at a mean age of 8.3 years (+/- 1.8, range 4-12 years). No amputation was needed, and satisfactory elbow and hand functions were obtained. Immediate close anatomic reduction and pinning with re-evaluation of hand perfusion is mandatory for SFH patients with suspected vascular injury before vascular exploration. (C) 2014 Wolters Kluwer Health vertical bar Lippincott Williams & Wilkins.