Pulled Elbow

Probably the most common traumatic elbow injury in children

– produced when the arm is pulled in pronation – longitudinal traction in pronation pulls the radial head distally by tearing the annular ligament attachment to the radius. As the traction is released, the annular ligament gets caught between the radial head and capitellum.

– rare after age 5

X-ray – make sure you are not missing a Monteggia or a congenital dislocation

“ The subluxation is then reduced by forcefully supinating the forearm with the elbow in 60-90 degrees of flexion. With the forearm forcefully supinated, the elbow is fully flexed maximally. The surgeon’s thumb is placed over the radial head and pushes down.”

– watch for the child to begin using the arm