Pulled elbow - An elbow injury to children while lifting

Who dont like children? On the verge of playing often children are lifted holding the hand and while doing this the the laxed elbow gets pulled and leave the child with cruciating pain. Children are too small to reveal their complaints, so it is very much necessary to assess the condition by their parents and doctors.

What is pulled elbow

Pulled elbow is also known as nursemaid elbow as it occurs in children between 2 to 5 years of age. In this case the head of the radius is pulled partly out of the annular ligament when a child is lifted by the wrist. There is intense pain and the child is unable to move the affected limb. The forearm lies in an attitude of pronation. There may be mild swelling at the elbow, but not always.

What can be the future effect of pulled elbow

The pulled elbow occurs when the head of the radius is still cartilagenous and not completely ossified, this may lead to improper ossification and in future there may be tendency of recurrent dislocation. Though dislocation of elbow is not so common as dislocation of shoulder joint.

Diagnosis of pulled elbow

Diagnosis completely depends on clinical examination which reveals the symptoms of pain and inability to move the limb or mild swelling. In X ray should be done, though it may not reveal any thing as the sublaxated head is still cartilagenous and that will not come in an X ray. Still x ray is done to rule out any other bony injury.

Treatment of pulled elbow

Immediately ice fomentation should be done, treatment of pulled elbow can be done at home by an expert, though it is not recommended.

The head is reduced by fully supinating the forearm and applying direct pressure over the head of the radius. A sudden click is heard or felt as the head goes back to its place.

The effect is seen immediately and the child becomes comfortable and can start moving his elbow almost at the same time after the head goes to its place.

At many places in the net it is mentioned that a cast may be given or a sling may be applied, but it is not necessary at all in case of pulled elbow. If the procedure above is not effective then there might be any other injury as well along with pulled elbow. In that case a sling may be applied before going to the doctor and get it diagnosed. In that case child may need analgesics too.