II. General
- Radial head subluxed beneath orbicular ligament
III. Epidemiology
- Most common between age 1-3 years
- Rare after 6 years old
IV. Mechanism
V. Symptoms and Signs
- Audible snap may be heard with Radial Head Subluxation
- Arm is held motionless at side
- Slight flexion
- Pronation
- Adduction
- Radial Head tender
VI. Imaging
- Elbow XRay Normal
VII. Management: Reduction
- Images
- Technique 1
- Cup affected elbow with opposite hand
- Apply pressure over radial head
- Thumb in antecubital fossa
- Apply slight longitudinal traction by grasping wrist
- Supinate (palm up) and flex (to 90 degrees) Forearm
- Palpable click felt with reduction
- Technique 2 (higher efficacy than supination with flexion)
- Elbow held in flexion
- Examiner positions thumb over radial head
- Hyperpronate Forearm
- Macias (1998) Pediatrics 102(1): e10 [PubMed]
VIII. Management: Post-reduction
- Child uses arm within 10-15 minutes
- Immobilization optional (Sling for 1-2 days)
- Child fails to use arm after 15 minutes
- Obtain Elbow XRay to rule out concomitant Fracture
- Elbow XRay normal but child still not using arm
- Posterior splint and sling
- Re-evaluate in 24 hours
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| Concepts | Injury or Poisoning (T037) |
| ICD9 | 832.2 |
| ICD10 | S53.03 |
| SnomedCT | 393609003, 95854004, 417109008 |
| English | Radial head subluxation, subluxation of radial head (diagnosis), subluxation elbow joint radial head, subluxation of radial head, elbow strain, elbow nursemaid, head radial subluxation, Strain;elbow, elbow strained, elbow nursemaids, elbow strains, elbow nursemaid's, nursemaid's elbow, pulled elbow, subluxation radial head, goyrand's injury, nursemaid elbow, radial head subluxation, Subluxation of the radial heads, Nursemaid's elbow, Pulled elbow (diagnosis), subluxation joint elbow radial head pulled, Goyrand's injury, Malgaigne's luxation, Nursemaids' elbow, Pulled elbow, Pulled elbow (disorder), Subluxation of radial head (disorder), Subluxation of radial head |
| Czech | Nursemaid's elbow |
| Dutch | zondagsarmpje |
| French | Coude de la bonne d'enfants |
| German | Kindermaedchen-Ellenbogen |
| Hungarian | Pronatio dolorosa infantum |
| Italian | Gomito della bambinaia |
| Japanese | ナースメイド肘, ﾅｰｽﾒｲﾄﾞﾋｼﾞ |
| Portuguese | Cotovelo da ama-seca |
| Spanish | Codo de niñera, codo de las niñeras, lesión de Goyrand, luxación de Malgaigne, luxación del codo (trastorno), luxación del codo, subluxación de la cabeza radial (trastorno), subluxación de la cabeza radial |
