Pulled elbow or “radial head subluxation.” is a common injury of early childhood and is referred to as “pulled elbow” because it occurs when a child’s elbow is pulled and partially dislocates at the radiocapitellar joint. Because a young child’s bones and muscles are still developing, it typically takes very little force to pull the bones of the elbow partially out of place, making this injury very common. It occurs most often in children ages 1 to 4, but can happen any time from birth up to age 6 or 7 years old. Although the injury may cause initial pain, a doctor or osteopath can easily reset the elbow, quickly relieving any discomfort and restoring arm movement. The annular ligament surrounds the radius and may be particularly loose in some young children, which may lead to it recurring over and over again.
In most cases of pulled elbow, the osteopath will gently move the bones back into normal position. The medical term for this procedure is “reduction.” The osteopath will hold the child’s wrist or forearm and turn the hand so that it faces palm up. While putting pressure near the top of the radius bone with his or her thumb, the doctor will slowly bend the elbow. A faint pop or click may be heard when the joint goes back into place. Although the child may experience some discomfort during the reduction, the pain subsides once the bones are placed back into the correct position. Many children will begin using the arm within minutes of the procedure, although it may take up to 24 hours for the pain to completely resolve and for the child to regain normal use of the elbow. Some children experience a pulled elbow over and over again. In these cases, the osteopath may teach the reduction manoeuvre to a parent or family member.
- Although some children’s elbow ligaments are weaker than others, making them prone to pulled elbow, there are guidelines parents and caregivers can follow that may prevent the injury.
- To safely lift a child, grasp gently under the arms. Do not lift children by holding the hands or arms.
- Do not swing a child by holding the hands or arms.
- Avoid tugging or pulling on a child’s hands or arms.