| Fractures
& Dislocations of the Child's Elbow > Radial Head Subluxation
in the Child (Nursemaid's Elbow) What Is Subluxation of the Radial Head? (“Nursemaid’s Elbow,” “Supermarket Elbow”) The two bones in the lower arm are the ulna and radius. The upper arm bone is the humerus. The two lower arm bones meet the upper arm bone at the elbow. As the most common elbow injury in young children, subluxation of the radial head happens when the elbow is pulled in the extended position. This occurs with a young child whose parent is holding his or her hand and yanks the arm while trying to prevent the child from falling. Nursemaid's elbow or subluxation occurs because the head of the radius has not matured and the pulling just longitudinally pulls the head partially out of the encircling ligament. The condition is most common in children under the age of 6 years because of a parent or sibling lifting, swinging or pulling a child by the arm when both the arm and elbow are extended. Causes of Subluxation of the Radial Head? Most often this condition is caused by a sudden pull or yank on the child's arm. This can happen if you are trying to keep the child from falling or even if you just are trying to hurry the child along. It is easy to prevent. Simply don't pull on your child's arms unless something worse will happen if you don't - like having a car hit him or her. This means don't pick them up or swing them by the arms either, instead pick him or her up by the torso. Symptoms of Subluxation of the Radial Head? If your child complains of elbow pain and holds the wrist of the hurt arm with his or her other hand, he or she may have nursemaid's elbow. Symptoms to watch for include:
Treatment is fairly straightforward. Most of the time, x-rays are not even needed. Most often, the doctor can just move the elbow back into place. To do this, he or she will gently bend the elbow to a 90 degree angle. The doctor will put his or her thumb over the elbow and apply a bit of pressure while starting to straighten the forearm. You might hear a snap when this happens, but that is to be expected. Once this is done, the child will usually feel much better and the pain will be gone. If the procedure is done within 12 hours of the injury, there is no need for a cast or splint. If it has been longer than that, though, a splint may be worn for about 10 days to help the ligament heal. If swelling or pain continues, the child may need x-rays to rule out a broken bone (see supracondylar fracture of the humerus). Once a ligament has been stretched though, it is easy for it to happen again. In fact, in about 25% of the cases of nursemaid's elbow, the condition reoccurs. For this reason, even once the arm feels better, it is important to not over-stretch it in the next few months so the ligament can fully heal. If the condition does reoccur, the child may need a cast for a few weeks to give the arm a rest. As the child grows the anatomy changes and the subluxations do not recur. The information provided herein is not intended to be a substitute for professional medical advice. You should not use this information to diagnose or treat a health problem or disease without consulting a licensed physician. © 2000 DynoMed.com, LLC, Indianapolis, IN |