Radial Head Subluxation (Nursemaid’s Elbow)

Basics

Description

  • Cause of acute upper extremity immobility and elbow injury in young children that results from axial traction on an extended arm
  • Also called “nursemaid’s elbow,” “babysitter’s elbow,” “toddler elbow” “pulled elbow,” “annular ligament displacement”

Epidemiology

  • Most common upper extremity injury among children <6 years of age
  • Peak incidence: 2 to 3 years of age
  • Age range: 0 to 11 years of age

Risk Factors

  • Female sex
  • Obesity

General Prevention

Avoid pulling child by arm; lift child from axilla.

Pathophysiology

Annular ligament in young children is more loosely connected to radial head.

Etiology

“Pull” on the arm or axial traction results in displacement of the annular ligament over the radial head, trapping it in the radiocapitellar joint, causing pain and refusal to move arm.

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