Article Sections

Introduction

Radial head subluxation, or nursemaid's elbow, is a common injury in children age 1-4 and is characterized by an entrapped annular ligament caused by axial traction (eg, pulling) of the arm.  The patient's presention includes a sudden refusal to move the affected arm, which is classically held close to the body with the forearm pronated and without deformity or swelling.

Pathogenesis and risk factors

The radial head is anchored to the ulna by the annular ligament, which encircles the proximal radius.  Sudden axial traction applied to a pronated forearm and extended elbow (eg, pulling the arm by the hand) can cause the annular ligament to slip over the radial head and become entrapped in the radiohumeral joint ( Figure 1).  The annular ligament displacement causes a limited range of motion at the elbow and pain with movement of the elbow and forearm.

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