Subluxation or Dislocation of the Radial Head

What is subluxation or dislocation of the radial head?

Subluxation or dislocation of the radial head is a common injury of the elbow joint. This condition, also referred to as a 'pulled elbow', 'babysitter’s elbow', or 'nursemaid’s elbow' is caused by a quick pull to the forearm. It is most common in children younger than six, though older children and adults can also develop this condition if the force on their arm is strong enough. People with this condition tend to hold the dislocated arm close to their body, and are unwilling to use the arm. They may report pain in the arm, and there may be a small amount of swelling around the elbow joint. Normally, the dislocation of the forearm (radial) bone is relocated by a doctor and complications are uncommon.

Risks

There are two bones in the forearm, the radius and the ulna. Both of these bones meet the bone of the upper arm, the humerus, at the elbow. The radius bone can be easily dislocated at the elbow in children, especially if the arm is straightened, because of their small size and small arm muscles. It is most common in children younger than six, though older children and adults can also develop this condition if the force on their arm is strong enough. This dislocation most commonly occurs when a child is holding hands with an older child or adult, who suddenly pulls on the child's arm, causing the bone to pop out of place.

Symptoms

People with this condition tend to hold the dislocated arm close to their body, and are unwilling to use the arm. They may report pain in the arm, and there may be a small amount of swelling around the elbow joint. If the injury is very severe, there might be a large amount of swelling around the elbow, the hand may become pale, and the child may complain of pins and needles in their arm (or a feeling that they hit their funny bone).

Diagnosis

The diagnosis of this injury is made based on a description of the injury, the symptoms and physical examination of the arm. An X-ray may be needed to check for broken bones before putting the bone back into place (relocation).

Treatment

The dislocated bone is usually quickly and easily relocated by a doctor. This is usually not very painful, and most children do not need any calming medication or pain relief for this procedure. If there has been damage to the tendons or a fracture (broken bone), surgery might be required to put the bone back into place.

Prevention

This condition can be avoided by not pulling firmly on the arm of young children.

Other names for subluxation or dislocation of the radial head

  • annular ligament displacement
  • radial head subluxation or dislocation
  • pronatio dolorosa