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Dislocated elbow in child, its cause & clinical feature

Last updated on September 11th, 2019 at 05:25 pm

dislocation of elbow children

Dislocated elbow in child also termed as a pulled elbow in toddler is a condition in which elbow joint of the child dislocates. Parent of the child often describes that when they were trying to lift child holding the hand they heard a click like sound and the elbow become dislocated.

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The dislocated elbow is clearly visible from outside.

In this article, we will try to understand what is pulled elbow in child, its causes, clinical feature, and its treatment.

Dislocated elbow in child

In pulled elbow head of the radius bone gets partially displaced from its place. In other words, there occurs subluxation of the radius bone head from the annular ligament.

Confused? Ok, to understand this we first need to know what is radius bone, annular ligament? We need to learn a little elbow anatomy.

Anatomy of elbow

Elbow joint is the junction of three bones, the humerus bone (bone of the arm), radius bone and ulna bone (radius & ulna bones are bone of the forearm). The radius bone is present on the outer side of forearm aligning the thumb and ulna bone aligns the little finger.

The upper end of the radius bone, we call it the head of the radius is surrounded by a ligament which holds the radius head and ulna bone together. This ligament is known as the annular ligament.

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In the pulled elbow, this annular ligament breaks and set the ulna bone free.

Clinical feature

  1. Common in children of 2 to 5 years of age. Usually occurs while trying to lift the child by holding the hand.
  2. Pain is the most important feature.
  3. swelling over the elbow and the child is reluctant to use the hand.
  4. X-ray does not reveal the subluxation as in children the head of the radius is not fully developed and is still in the cartilaginous form.
pulled elbow toddler

Straight long line is the Radius bone (arrow is the ulna bone). Note the
half grown radial head.

Treatment

Closed reduction (displaced bone is replaced without any surgical intervention) of dislocation is done by the surgeon. After which sling is given for a week. One must avoid any massage over the elbow.

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Dr Sunit Sanjay Ekka is a physiotherapist in practice for the last 15 years. He has done his BPT from one of the premium Central Government physiotherapy colleges, ie, SVNIRTAR. The patient is his best teacher and whatever he gets to learn he loves to share it on his Youtube channel and blog.

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