Skip to main content

Radial Head Dislocation and Subluxation (Nursemaid’s Elbow)

J. Herbert Stevenson, MD Reviewed 06/2019
 


BASICS

DESCRIPTION

  • Subluxation more common in children. In both adults and children, typically associated with distracting force across elbow or trauma; dislocation more common in men subject to high-f...

DIAGNOSIS

HISTORY

  • Subluxation in children is typically associated with an upward axial distracting force (“yank” on the arm) with subsequent refusal to move the affected arm.

  • Adult patients with isolate...

TREATMENT

GENERAL MEASURES

  • Reduction of the radial head can occur spontaneously and is relatively easy to perform in the office.

    • Using the supination–flexion technique: With the forearm pronated and t...

ONGOING CARE

FOLLOW-UP RECOMMENDATIONS

Cases of radial head dislocation should be followed up to evaluate range of motion. 

PROGNOSIS

  • Early reduction of radial head dislocations is associated with better...

REFERENCES

1
Kim MC, Eckhardt BP, Craig C, et al. Ultrasonography of the annular ligament partial tear and recurrent “pulled elbow.” Pediatr Radiol.  2004;34(12):999–1004. [View Abstract on OvidMe...

ADDITIONAL READING

  • Fassier AM, Rauch F, Aarabi M, et al. Radial head dislocation and subluxation in osteogenesis imperfecta. J Bone Joint Surg Am.  2007;89(12):2694–2704. [View Abstract on OvidMe...

CODES

ICD10

  • S53.033A Nursemaid’s elbow, unspecified elbow, initial encounter

  • S53.031A Nursemaid’s elbow, right elbow, initial encounter

  • S53.032A Nursemaid’s elbow, left elbow, initial encounter

ICD9

  • 832.2 ...

CLINICAL PEARLS

  • Consider subluxation of the radial head when children suddenly stop using their arm and hold it in extension/pronation.

  • Hyperpronation can reduce nursemaid’s elbow if supination/flexion...

Subscribe to Access Full Content

Sign Up for a 10-Day Free Trial

Sign up for a 10-day FREE Trial now and receive full access to all content.

×