Big hand holding small hand, beware of "elbow pulling"

1. What is “pulled elbow”?

"Stretched elbow", also known as "elbow dislocation", "elbow dislocation", is clinically called radial head subluxation. It often occurs in children under 5 years old. Because the radial head of children is underdeveloped, the annular ligament surrounding the radial head is relatively weak. The main function of the annular ligament is to limit the range of motion of the radial head so that it will not dislocate. When the elbow is pulled in the extended position, the radial head is stuck and cannot return to the normal anatomical position, resulting in radial head subluxation.

2. Under what circumstances is "pulled elbow" likely to occur?

1. Pulling the child's wrist hard when going up the stairs or falling when walking fast while holding the child's wrist

2. Hold your child’s arm to swing or pull your child’s arm to spin in circles

3. Pull the child's upper limbs when dressing the child

3. What are the symptoms of “pulled elbow”?

After radial head subluxation, the child will usually cry and make a fuss. The arm on the dislocated side will hang down weakly, and the child will not dare to move or touch the arm. There will be obvious tenderness on the outside of the elbow. Some children cannot clearly describe the symptoms, but they will refuse to use or move the arm on the dislocated side.

4. How to treat “pulled elbow”?

It is recommended that parents take their children to the nearest hospital's orthopedic department for treatment. Generally, X-ray examination is not required for traction elbow, but if the child's elbow cannot move due to a fall, and there is obvious local swelling or even deformity of the elbow, an X-ray examination is required to rule out fractures.

Generally, manual reduction can be performed without anesthesia. The reduction method is as follows: the operator holds the child's wrist with one hand and supports the elbow with the other hand, presses the thumb on the radial head, flexes the elbow joint 90°, and gently pronates and supinates the forearm, repeats several times, and pushes around the bone with the thumb to reduce the reduction. The sign of successful reduction is a slight snap and normal elbow movement. After reduction, it is not necessary to fix it, but parents are warned not to pull the affected limb violently to avoid recurrence.