Suspected Radial Head Subluxation in Infants

Hanes, Lauren; McLaughlin, Robyn; Ornstein, Amy

doi:10.1097/pec.0000000000001848

Cited by 6 publications

(9 citation statements)

References 6 publications

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“…However, imaging should be done if the reported history or clinical presentation is not consistent with pulled elbows, especially if there is evident swelling or bruising and a fracture was suspected (1,11) . Hanes et al (12) even recommend that all nonambulatory infants with unclear history should have Xray done, since manipulation of a missed elbow fracture can be potentially harmful (13) .…”

Section: Discussionmentioning

confidence: 99%

Atypical Presentation of Nursemaid's Elbow: A Case Report

Mohamed¹,

Ali²,

Nawaz³

2023

The Egyptian Journal of Hospital Medicine

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Background: Nursemaid's elbow is a known orthopedic pediatric emergency that occurs between one and four years of age. Axial traction of the extended arm when the forearm is pronated is the most frequently reported mechanism of infliction. However, other mechanisms are mentioned in the literature. Cases report: We report a case of pulled elbow in a four-month-old child. The mother reported that the child only rolled over to her side. Conclusion: A high index of suspicion for pulled elbow should be kept in younger infants despite the absence of the usual presentation.

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Section: Discussionmentioning

confidence: 99%

Atypical Presentation of Nursemaid's Elbow: A Case Report

Mohamed¹,

Ali²,

Nawaz³

2023

The Egyptian Journal of Hospital Medicine

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“…1. In patients younger than 5 years: • a concerning mechanism (high energy trauma, direct blow) • significant elbow swelling on physical examination (beyond the lateral aspect of the radial head) • tenderness over the distal humerus or proximal ulna • any bony deformity • inability to successfully reduce a pulled elbow • nonambulatory patients, usually younger than 1 year, without a history of arm caught under body when rolling over, 22 or arm being pulled. 2.…”

Section: Discussionmentioning

confidence: 99%

“…• nonambulatory patients, usually younger than 1 year, without a history of arm caught under body when rolling over, 22 or arm being pulled.…”

Section: Discussionmentioning

confidence: 99%

Overutilization of Radiographs for Pulled Elbow Among Orthopedic Surgeons Compared With Pediatricians

et al. 2022

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BackgroundPulled elbow is a common pediatric condition, treated by pediatricians and orthopedic surgeons. The diagnosis is clinical, and imaging is only required where an occult fracture is suspected, although overuse is reported. In this study, we explore the epidemiology of pulled elbow in Israel, focusing on the differences in management between physicians of various specialties.MethodsElectronic medical records of the largest health provider in Israel, which provides health services to more than 50% of the population, were reviewed for pulled elbow cases between 2005 and 2020. Patients aged 4.5 months to 7 years were included. Demographic information, the discipline of the treating physician, and acquisition of elbow radiographs were gathered.ResultsA total of 4357 patients, 62.8% girls, were included. The average body mass index was 16.1 (SD, 1.2). Most patients were from communities in the upper half of the socioeconomic status clusters 6 to 10 (64.63%). Most patients were attended by a pediatrician (51.5%), followed by an orthopedic surgeon (19.9%). Radiographs were acquired for 570 children (13.1%). Most radiographs (36.5%) were requested by orthopedic surgeons and for children in the boundary age groups. The patient's socioeconomic status was associated with access to physicians of different subspecialties, and lower income families had a higher tendency to be treated by nonspecialized physician (P < 0.001).ConclusionsOrthopedic surgeons use elbow radiographs much more than pediatricians; effort should aim at reducing the imaging rate for this population.

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“…More than 3 attempts are usually an indication for further evaluation. [1,2]. There has been lot of literature support for hyper-pronation maneuver for reducing the pulled elbow with some studies proving it more efficient for reduction of pulled elbows in the first attempt .…”

Section: Reductionmentioning

confidence: 99%

“…Table 1 shows the red flag signs which would mandate a radiograph or further evaluation before reduction. [1] .…”

Section: Introductionmentioning

confidence: 99%

Managing a pulled elbow in the clinic

Shah¹,

Agashe²

2022

Jcorth

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Pulled elbow is one of the commonest clinical conditions encountered by the Paediatric orthopaedic surgeon. It is primarily due to axial force applied to a semi-prone forearm which leads to proximal radio-ulnar joint dislocation. Diagnosis is usually clinical and radiographs are rarely needed. Reduction maneuvers include the Traction-supination and traction-hyperpronation method and almost always cause immediate pain relief and return to function.

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Suspected Radial Head Subluxation in Infants

Cited by 6 publications

References 6 publications

Atypical Presentation of Nursemaid's Elbow: A Case Report

Atypical Presentation of Nursemaid's Elbow: A Case Report

Overutilization of Radiographs for Pulled Elbow Among Orthopedic Surgeons Compared With Pediatricians

Managing a pulled elbow in the clinic

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