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Nursemaid’s Elbow, Sports Medicine

Reviewed 04/2019
 


BASICS

DESCRIPTION

  • Results from a traumatic subluxation of the radial head, which is produced by sudden forcible traction on the pronated hand or wrist with the relaxed elbow extended

  • Subluxation of the...

DIAGNOSIS

  • History alone is the basis for diagnosis in most cases.

  • Consider prereduction radiographs if there is a history of trauma.

  • Postreduction views are unnecessary.

  • Consider x-rays if the child’s ar...

TREATMENT

GENERAL MEASURES

  • Analgesia:

    • Not typically necessary for reduction

    • Consider acetaminophen (15 mg/kg) or ibuprofen (5 to 10 mg/kg) as needed.

  • Reduction techniques: flexion–supination and hyperpron...

ONGOING CARE

FOLLOW-UP RECOMMENDATIONS

  • Even when multiple attempts at closed reduction fail, spontaneous reduction almost always occurs.

  • Usually no long-term sequelae

  • Consider an occult fracture or carti...

REFERENCES

1
Vitello S, Dvorkin R, Sattler S, et al. Epidemiology of nursemaid’s elbow. West J Emerg Med.  2014;15(4):554–557.
2
Wong K, Troncoso AB, Calello DP, et al. Radial head subluxation: fact...

ADDITIONAL READING

Schunk JE. Radial head subluxation: epidemiology and treatment of 87 episodes. Ann Emerg Med.  1990;19(9):1019–1023. 

CLINICAL PEARLS

  • Commonly occurring traction injury age <4 yr

  • Educating families to avoid pulling or putting traction on the child’s arm for several days following injury significantly decreases the ...

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