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Radial Head Dislocation and Subluxation (Nursemaid’s Elbow)

Lee A Mancini, CAQSM, CSCS*D, CSN, MD, Craig A Pille, MD and Emily J Eshleman, MS, DO Reviewed 05/2023
 


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 the...

ONGOING CARE

FOLLOW-UP RECOMMENDATIONS

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

Patient Monitoring

In childhood subluxation, anticipatory guidance and educatio...

REFERENCES

1
Kim  MC, Eckhardt  BP, Craig  C, et al. Ultrasonography of the annular ligament partial tear and recurrent “pulled elbow.” Pediatr Radiol. ...

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–...

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

SNOMED

  • 9585...

CLINICAL PEARLS

  • Consider subluxation of the radial head when children suddenly stop using their arm and hold it in flexion, especially after upward axial distracting force or fall on outstretched arm.

  • ...

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