Nursemaid’s Elbow (Annular Ligament Displacement)

1. Eric A. Browner, MD 1. University of Medicine and Dentistry New Jersey, Robert Wood Johnson Medical School, Bristol-Myers Squibb Children’s Hospital, New Brunswick, NJ 1. 1. Joffe MD, 2. Loiselle JM 1. Fleisher GR, 2. Ludwig S Annular Ligament Displacement (Radial Head Subluxation). Joffe MD, Loiselle JM. In: Fleisher GR, Ludwig S, eds. Textbook of Pediatric Emergency Medicine. 6th ed. Philadelphia, PA: Lippincott Williams & Wilkins; 2010:1574–1575 2. 1. Krul M, 2. van der Wouden JC, 3. van Suijlekom-Smit LWA, 4. Koes BW Manipulative Interventions for Reducing Pulled Elbow in Young Children. Krul M, van der Wouden JC, van Suijlekom-Smit LWA, Koes BW. Cochrane Database Syst Rev. 2012;1:CD007759. DOI: 10.1002/14651858.CD007759.pub3 3. 1. Meckler GD, 2. Spiro DM Technical Tip: Radial Head Subluxation. Meckler GD, Spiro DM. Pediatr Rev. 2008;29:e42–e43 [OpenUrl][1][FREE Full Text][2] 4. 1. Price CT, 2. Flynn JM 1. Morrissy RT, 2. Weinstein SL Radial Head Dislocation and Nursemaid’s Elbow. Price CT, Flynn JM. In: Morrissy RT, Weinstein SL, eds. Lovell & Winter’s Pediatric Orthopedics. 6th ed. Philadelphia, PA: Lippincott Williams & Wilkins; 2006:1463 Nursemaid’s elbow is a relatively frequent pediatric joint injury that occurs most often in children ages 6 months to 5 years. Previously described as subluxation of the radial head, nursemaid’s elbow is now referred to by the preferred and more anatomically correct term annular ligament displacement . The annular ligament normally is located just below the radial head as it passes around the proximal radius. The injury typically results from a traction force applied to a pronated arm, such as when a child is pulled up by the hand or falls suddenly when being held by the hand. This movement allows the annular ligament to slip over the head of the radius and come to rest in the radial-humeral joint between the radius and capitulum, where it becomes entrapped. Although a traction force is the most common mechanism of this injury, often no definite history of a typical pull or fall can be obtained. Nonetheless, this injury should be suspected when a child is reported to resist moving his or her arm and is found to be holding it against the body and slightly flexed. The child usually is not in pain when left alone and the arm is not being manipulated. Parents often believe that the child’s wrist or shoulder is injured because attempts to move these joints also cause movement of the elbow … [1]: {openurl}?query=rft.jtitle%253DPediatrics%2Bin%2BReview%26rft.stitle%253DPediatr.%2BRev.%26rft.issn%253D0191-9601%26rft.aulast%253DMeckler%26rft.auinit1%253DG.%2BD.%26rft.volume%253D29%26rft.issue%253D7%26rft.spage%253De42%26rft.epage%253De43%26rft.atitle%253DTechnical%2BTip%253A%2BRadial%2BHead%2BSubluxation%26rft_id%253Dinfo%253Adoi%252F10.1542%252Fpir.29-7-e42%26rft_id%253Dinfo%253Apmid%252F18593750%26rft.genre%253Darticle%26rft_val_fmt%253Dinfo%253Aofi%252Ffmt%253Akev%253Amtx%253Ajournal%26ctx_ver%253DZ39.88-2004%26url_ver%253DZ39.88-2004%26url_ctx_fmt%253Dinfo%253Aofi%252Ffmt%253Akev%253Amtx%253Actx [2]: /lookup/ijlink?linkType=FULL&journalCode=pedsinreview&resid=29/7/e42&atom=%2Fpedsinreview%2F34%2F8%2F366.atom