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(Pediatrics in Review. 2008;29:e42-e43.)
© 2008 American Academy of Pediatrics

Technical Tip

Radial Head Subluxation


Garth D. Meckler, MD, MS*
David M. Spiro, MD, MPH*
 * Departments of Emergency Medicine & Pediatrics, Section of Pediatric Emergency Medicine, Oregon Health and Science University, Portland, Ore

The first 20% of the full text of this article appears below.


   Case Presentation
 
A previously healthy 6-year-old girl presents with an inability to move her left upper extremity for 24 hours. There is no history of trauma or evidence of injury on physical examination. The parent denies the presence of fever. The child slept well the night before, and her appetite has been normal.


   Introduction
 
Reduction of a radial head subluxation is a gratifying procedure for both clinicians and parents. With a simple maneuver, a child can be restored to full function in minutes, without the need for costly or time-consuming studies. Radial head subluxation also is referred to as nursemaid's elbow, pulled elbow, or annular ligament displacement. Clinicians working in the office, urgent care center, or emergency department should be familiar with this common diagnosis.


   Epidemiology
 
Radial head subluxation has been identified as the most common orthopedic injury among children younger than 6 years of age. It has been described in infants as young as 2 months of age, but has a peak incidence among toddlers, with a mean age of 27 months. Girls are affected more often than boys, and the left arm is involved more often than the right, likely due to most parents being right-handed.


   Anatomy and Pathophysiology
 
Much debate has surrounded the exact anatomic, developmental, and mechanistic explanations for . . . [Full Text of this Article]


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