One of the bones that makes up the elbow (radial head) slips out of a ligament (see diagram). This not a dislocation. This happens because the child's joints have not completed development and the ligament is looser at this age.
What causes a pulled elbow?
Usually the arm is pulled accidently or stretched, examples include:
- You and your child moving in opposite directions quickly whilst holding hands
- Lifting yourchild by one hand
- Pulling an arm through a sleeve whilst dressing
Sometimes it may occur following a fall or there is no recollection of injury.
Symptoms:
Following an incident your child may display the following features:
- Usually the child is not distressed
- Reluctant to use the arm
- Will hold the arm by their side
- Child may report hearing a pop
How is it diagnosed?
For most cases no x-ray is required as the history is clear-cut.
When there is doubt an x-ray will be taken.
How is it treated?
The treating clinician will perform a short gentle manoeuvre (bend the elbow and turn the wrist). A pop may be felt or heard and your child may begin to cry. This is not due to pain but due the sensation something has suddenly changed. Shortly after this your child will be able to use their arm normally, especially if they are distracted by playing with a toy. The longer the elbow has been out of place, the longer it takes to fully recover.
If the manoeuvre was unsuccessful your child will be provided with a sling and asked to return to the department within 48 hours for review. During this time many cases resolve without intervention, should this occur please phone the department to inform us your child is using their elbow normally.
Complications
A pulled elbow may occur again up to the age of 7-8 years, thereafter the bones in the elbow mature so that it no longer slips out of the ligament.
A pulled elbow will not cause any long term damage to your child.
Prevention
To prevent this happening it is best to avoid pulling/lifting your child up from their wrists or hands.
Accessible formats
NHS Fife provides a range of ways in which you can communicate with us. You can use our website with its accessible functions, these will help you find and understand the information you need. You can also find a variety of translated materials in community languages and in British Sign Language.
If you require interpreting services, you can contact us by emailing fife.EqualityandHumanRights@nhs.scot, by calling 01592 729130, or using the NHS Fife SMS text service on 07805800005 which is available for people who have a hearing or speech impairment.