Pulled elbow
Epidemiology
- Typically effects young children (under 5)
Presentation
- Children will hold elbow flexed and forearm prone with reluctance to supinate
Mechanism
- Typical caused by axial traction on the forearm/hand e.g. a parent lifting child up by their arm.
- This allows the radial head to sublux and the annular ligament interposes the radiocapitellar joint
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Management
- XRAY, if taken, is typically normal
- Often resolves spontaneously
- Typically easily reduced by supination or pronation movement of the forearm
Traditional reduction is achieved by flexing the elbow to 90º and then fully supinating or pronating the forearm, there may often be an associated click and the child will begin using the arm a short time later.