Radial head dislocation
A dislocation means the displacement of a body part (usually a joint) from its normal location. In a radial head dislocation, the forearm slips out of position at the elbow joint.
Alternative NamesNursemaid's elbow; Pulled elbow; Partial elbow dislocation; Elbow subluxation
This is a common but easily preventable injury in 1- to 3-year-old children.
Once the elbow dislocates, it is likely to do so again, especially in the three or four weeks following the injury.
Causes of Radial head dislocation
This injury occurs frequently among toddlers. It is caused by a sudden pull on the child's arm or hand. It typically occurs when an adult pulls the child up from the hand, often to prevent a fall, to assist the child up a curb or step, or to hurry the child along. Swinging toddlers from the arms while playing can also cause this injury.
This injury, also commonly called a "nursemaid's elbow" does not usually occur after age 5. By this time, children's joints and ligaments are stronger, and they are less likely to be in a situation where this injury might occur. However, in some cases, the injury can occur in older children or adults, usually from a fracture in the forearm.
Symptoms for Radial head dislocation
- Immediate pain anywhere between the hand and the elbow
- Persistent crying after incident
- Inability or refusal to move affected limb (may clutch the arm next to body)
- Refusal to play
- Palm of hand faces down on the injured arm
- Swelling may occur several hours after the injury
First Aid for Radial head dislocation
1. Apply an ice pack to the elbow.
2. Splint the injured arm in the position in which you found it. Immobilize the area both above and below the injured joint, including the shoulder and the wrist if possible.
3. Take the child to the doctor's office or emergency room. In some cases of frequently recurring nursemaid's elbow, your physician may teach you how to attempt to relocate the elbow yourself. This is done by supinating (externally rotating) the forearm (in other words, turning the thumb out with palm up), then gently flexing the arm at the elbow (pushing the forearm up into the biceps).
- DO NOT Move the child without first splinting the arm.
- DO NOT Attempt to straighten the arm or change its position.
- DO NOT Make this diagnosis without a clear history of someone pulling on the arm
When to Contact a Health Professional
Although this injury is usually not a medical emergency, you should call for immediate medical attention if any of the above symptoms is present.
Prevention of Radial head dislocation
- Do not yank or pull children by the hand or forearm. Lift small children from under the arms.
- Do not swing children by the hand or forearm. To swing a young child in circles, provide support under the arms and hold the upper body next to yours.
Reviewed By: Kevin B. Freedman, MD, MSCE, Sports Medicine, Orthopaedic Specialists, Bryn Mawr, PA. Review provided by VeriMed Healthcare Network.
Copyright 2013 A.D.A.M., Inc.