Pulled Elbow – The wailing child with no fracture

A good history – if classical and clinical evaluation is all that is required for a diagnosis. Often an x-ray is not necessary. I request for an x-ray to rule out a fracture around the elbow if the examination of the child me doubt the diagnosis of a pure pulled elbow – this usually is the case if the elbow is unduly swollen.

Manipulation is done in the clinic-emergency room. If done correctly – with reduction of the radial head, the child is comfortable within minutes and often starts using the limb. It is therefore important to review the child after 15-20 minutes. An arm sling is often used but often unnecessary with the child often discarding it within hours.

Credit – Images from Netter’s Atlas of Orthopaedics