Investigation on 2331 Cases of Pulled Elbow over the Last 10 Years

Abstract

Pulled elbow is a common upper extremity injury in children. We present a retrospective study of 2331 pulled elbow cases examined in our hospital over the last ten years. All pediatric patients with a diagnosis of pulled elbow from January 2002 to December 2011 were retrospectively reviewed according to sex, age, affected arm, recurrence rate, mechanism of injury and treatment outcomes. There is no significant sex difference. The frequency of injury peaked for both boys and girls at 6 months and 2 years of age. The left arm was more affected than the right. The recurrence rate was 14%. In about 50% of cases, the cause of injury was forcible traction to the forearm. Almost all of the splinted patients, caused by severe pain or lack of mobility of the affected limb following reduction, recovered within 2 weeks, but 2 were later diagnosed with a fracture. For infants less than 1 year old, injury can often occur when rolling over. For children 1 year old or older the left arm is more commonly affected, and the frequency of injuries to the left arm increases with age, possibly because the left hand is commonly held by the guardian’s dominant right hand and faster development of muscle strength in the child’s dominant right arm works toward preventing injury to that arm with age.

The use of ultrasonography for the confirmation of pulled elbow treatment

“…So, the result of this case report is in line with our study. A study investigating 2331 cases of pulled elbow over the last 10 years by Irie et al is inconsistent with our study (17). In this study, all pediatric patients with a diagnosis of pulled elbow from January 2002 to December 2011 were studied according to sex, age, affected arm, recurrence rate, mechanism of injury and treatment outcomes.…”

Late Arrival at the Hospital with Pulled Elbow: An Issue Missed by Parents

“…Pulled elbow is a common injury among children aged between 1 and 3 years (1,2). Boys are more commonly affected than are girls, and left-side injury is seen more than is right-side injury (5).…”

“…Pulled elbow is typically diagnosed in emergency departments in children younger than 5 years of age (1,2). The injury mechanism is a forceful traction applied to an extended and pronated arm (2,3). The incidence of this injury is 3.0% in children younger than 8 years of age (4).…”

Current views on radial head subluxation

“…Ядро окостенения в проксимальном метафизе лучевой кости появляется только в промежутке между 3 и 5 годами. Эластичная головка лучевой кости без ядра окостенения не препятствует соскальзыванию анулярной связки и смещению ее в полость сустава [6,20]. Головка лучевой кости как у детей, так и у взрослых имеет эллипсовидную форму.…”

“…В положении пронации предплечья головка поворачивается кпереди малым диаметром, что также способствует соскальзыванию анулярной связки [21]. По данным T. Irie et al, после 7 лет головка лучевой кости расширяется в стороны, что затрудняет соскальзывание анулярной связки [20]. Классическим обстоятельством, при котором происходит ПГЛ, является внезапная и резкая тракция за кисть или предплечье ребенка, которого ведут или пытаются поднять за руку (например, при падении или сопротивлении).…”