What is radial head subluxation?

Updated: Apr 08, 2020
  • Author: Gretchen S Lent, MD; Chief Editor: Erik D Schraga, MD  more...
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Radial head subluxation, also known as pulled elbow or nursemaid’s elbow, is one of the most common upper-extremity injuries in infants and young children who present to the emergency department (ED). Reduction of the subluxated radial head is easily performed in the ED, and complications are rare.

Subluxation of the radial head is a minor soft-tissue injury that has a peak incidence in children aged 2-3 years and generally affects children younger than 6 years. [1] Although occurrence outside this population is uncommon, radial head subluxation does occur in patients younger than 6 months, as well as in older children and even adults. [2]

Subluxation of the radial head typically results from a quick pull on a child’s arm (see the image below). [3] Often, this occurs when a child is holding hands with a caregiver who lifts the child by the arm or tries to prevent a fall. Parents therefore may provide a history of a fall preceding the injury. Frequently, however, caregivers are unsure what caused the injury because the causative mechanical force can be minor or even trivial. [4] Rarely, underlying musculoskeletal abnormalities may precipitate a subluxation. [5]

Subluxation of radial head occurs after longitudin Subluxation of radial head occurs after longitudinal traction is placed on pronated extended arm.

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