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Radial Head Subluxation (Nursemaid’s Elbow), Pediatric

Meredith C. Laguna, MD, MPH and Steven Bin, MD Reviewed 10/2018
 


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,”...

DIAGNOSIS

HISTORY

  • Child suddenly not using one arm, frequently with unknown mechanism

  • More commonly left arm

  • May describe an injury occurring when a caregiver holds the child’s arm and the child pulls aw...

TREATMENT

GENERAL MEASURES

There are two types of reduction maneuvers; both maneuvers can be performed in the office or ED without need for sedation. 
  • Hyperpronation method:

    • Support the elbow with one ha...

ONGOING CARE

FOLLOW-UP RECOMMENDATIONS

With successful reduction, no routine follow-up required 

PATIENT EDUCATION

  • Prevention with lifting technique; avoid pulling child’s arm.

  • Teach caregivers reduction ...

ADDITIONAL READING

  • Aylor M, Anderson JM, Vanderford P, et al. Videos in clinical medicine. Reduction of pulled elbow. N Engl J Med.  2014;371(21):e32. [View Abstract on OvidInsights]

  • Bexkens R, Wa...

CODES

ICD9

832.2 Nursemaid’s elbow 

ICD10

  • S53.03 Nursemaid’s elbow

  • S53.032 Nursemaid’s elbow, left elbow

  • S53.031 Nursemaid’s elbow, right elbow

  • S53.033 Nursemaid’s elbow, unspecified elbow

  • S53.031A Nursemaid...

FAQ

  • Q: Are radiographs required if mechanism is unknown prior to performing attempted reduction?

  • A: If arm is held in classic position, close to body, minimally flexed at elbow and forearm pronated, wi...

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