- What Is It?
- How to Prevent
What is a radial head subluxation?
The elbow is made up of the upper arm bone (humerus) and two bones in the forearm (radius and ulna). Some strong ligaments in the elbow hold these bones in the elbow joint together.
A radial head subluxation occurs when the radius bone slips partially out of the elbow joint. It is known as a nursemaid’s elbow. It occurs most commonly in children, particularly below six years of age. Two to three years is the most affected age group in children.
The two joints in the elbow are:
Humeroulnar joint: This joint is between the ulna and humerus that allows the bending of the elbow.
Radiocapitellar joint: This joint is between the radius and humerus that allows the rotation of the forearm to turn the palm up or down.
A nursemaid's elbow occurs when there is a subluxation of the radiocapitellar joint.
What causes a radial head subluxation?
In children, ligaments around the elbow are not as developed as they are in adults, therefore it takes only a little force to pull the radius out of its place in the elbow. This usually happens when children are pulled from their wrist with their hands in extension or pulled suddenly from their arms. Generally, caregivers do this to avoid the child from falling from steps or stopping the child from doing something dangerous.
A radial head subluxation may also occur when a child is held by his/her wrist and swung around playfully.
Radial head subluxations rarely happen because of a fall. If the child’s elbow becomes extremely painful and he/she refuses to move his/her arm after a fall, then there may be more to a radial head subluxation - there may be a complete radial head dislocation or/and a fracture.
Patients with previous radial head fractures are more likely to get a radial head subluxation.
What are the signs and symptoms of a radial head subluxation?
Using the arm with a radial head subluxation will be extremely painful for the child. Hence, the child will hold the arm close to his/her body and refuse to bend or rotate the elbow or use the arm.
How does the doctor diagnose a radial head subluxation?
A doctor can usually diagnose radial head subluxations by looking at how the child is holding his/her arm.
Although an X-ray is not required for your doctor to diagnose a radial head subluxation, he or she may order one to make sure there is no fracture.
What is the reduction of a radial head subluxation?
The doctor will gently move the bones back into their normal position to fix a radial head subluxation. This procedure is known as reduction of a radial head subluxation and is done as follows:
- The doctor will hold the child’s wrist or forearm and rotate the hand outward till the palm faces up.
- While pressing near the top of the radius bone with his or her thumb, the doctor will slowly bend the elbow.
- When this happens, a small click may be heard which means reduction has been achieved.
What happens after the reduction of a radial head subluxation?
Following the reduction, the child gets immediate relief from the elbow pain.
The doctor will leave the child and return after 10 minutes to check if the child can move his/her affected arm. Sometimes, the child may take 30 minutes to resume moving his/her hand normally.
If the child is still unable to move his/her hand normally, the doctor will repeat the reduction. If the child does not begin using the arm normally after such repeated attempts, an X-ray of the elbow will be taken to observe for broken bones.
Although a sling may be placed on the elbow for 24 hours, it is not required for most patients. Only if the symptoms last for several days, a sling may be worn for longer.
How can a radial head subluxation be prevented in children?
It is easy to prevent radial head subluxations in children by just taking a few precautions:
- Do not swing a child by holding his/her hands or arms.
- Do not tug or pull on a child’s hands or arms.
- Lift a child safely by grasping gently under his/her arms and not by holding his/her hands or arms.
Health Solutions From Our Sponsors
Reduction of Radial Head Subluxation. Available at: https://emedicine.medscape.com/article/104158
Nursemaid’s elbow. Available at: https://orthoinfo.aaos.org/en/diseases--conditions/nursemaids-elbow
Top Radial Head Subluxation Nursemaid Elbow Related Articles
Dislocated ElbowAn elbow dislocation occurs when the radius and/or ulna becomes displaced from the humerus. Typically, falls cause dislocated elbows. Signs and symptoms include pain, visible deformity, an audible pop, swelling, and an inability to move the elbow. Treatment may incorporate pain medications, reduction of the elbow joint, and wearing an elbow brace to protect the joint as it heals.
Elbow PainElbow pain is most often the result of tendinitis, which can affect the inner or outer elbow. Treatment includes ice, rest, and medication for inflammation. Inflammation, redness, warmth, swelling, tenderness, and decreased range of motion are other symptoms associated with elbow pain. Treatment for elbow pain depends upon the nature of the patient's underlying disease or condition.
Pain QuizIs pain all in the brain? Take the Pain Quiz to learn everything you've ever wanted to know about the unpleasant sensation we call pain.
Pain Management: Surprising Causes of PainWhat’s causing your pain? Learn the common causes of lower back pain, as well as pain in the knee, stomach, kidney, shoulder, chest, gallbladder, heel, sciatic nerve, neck, hip, foot and other parts of the body. Find pain management tips that work to help lower pain triggers, as well as other pain treatments.
15 Ways to Reduce PainChronic pain can be a symptom of many conditions, including arthritis, headaches, and others. Comprehensive pain management therapy may include physical therapy, lifestyle strategies such as exercise, diet changes, meditation, journaling, medications, and avoiding alcohol and tobacco use. Make helpful changes to manage your chronic condition.
What Is the Reduction of Posterior Elbow Dislocation?The posterior elbow is dislocated when you fall on your extended arm. It is more common in adolescent athletes, particularly those who are engaged in sports such as football and wrestling.
What is Reduction of Radial Head (Elbow) Dislocation?The reduction of dislocation is a procedure to manipulate the bones back to their normal position. If this is performed externally, that is, without opening the arm, it is known as closed reduction.
What Is a Posterior Elbow Splint?A posterior elbow splint is affixed to the arm to stabilize a dislocated elbow. A splint is a type of a medical tool made of rigid material to immobilize a fractured or dislocated bone. A splint usually helps to maintain any part of the body in a fixed position. The most common use of splints is in emergency settings to keep a broken bone in position until it heals or until a doctor can set it with a more comprehensive procedure.
What Is Elbow Arthrocentesis?Elbow arthrocentesis is a minor procedure that involves removing the fluid (synovial fluid) from the elbow joint cavity through a needle (aspiration) The aspirated fluid is then sent to a lab for further analysis. This aspirated fluid helps to diagnose the cause of elbow swelling and underlying diseases. The procedure is usually done under local anesthesia and causes mild pain. Patients are usually discharged on the same day.