Parents should not play with their children like this. Children under the age of 5 are prone to this kind of arm injury.

In the park, you may see such a scene as the above picture:

It’s very common, isn’t it?

Sometimes you will see that after playing like this, the child’s expression changes from laughter to crying for a moment, and his parents are not allowed to touch his hand.

What’s going on here?

This is [playing off].

Did you take it off? Where did you take it off?

In fact, the so-called “playing off” means that the child has subluxation of the radial head.

What manifestations do children have and should be on guard against subluxation of radial head?

When a child’s hand or upper limb is suddenly pulled, The radial head will be pulled away from its original position, and then the tissues around the radial head (such as annular ligament) will easily [run] between the humeral capitulum and the radial head. When the radial head is to be restored to its original position, the annular ligament will not shrink back, resulting in the radial head not being able to return to its original position, thus causing subluxation of the radial head.

STEP 1 Cry

Because of the sudden severe pain, the child will cry in an instant.

Step 2 Refuse to touch

In order to relieve the pain, the child will try his best not to move the injured hand and will refuse others to touch it.

Step 3 Bend the affected limb

Children will make the injured arm half flexed. Generally, swelling will not occur.

Recall whether the following actions have occurred?

Generally speaking, the following actions may cause subluxation of radial head:

1. Grab the child’s hand to prevent him from falling down.

2. Grab the child’s hand or wrist and try to pull the child up.

3. Grab the child’s hand and let the child put the gloves into the sleeve of the coat.

4. Pull the child’s hand or wrist back and forth ([human swing] or [human pendulum])

5. Give the child a yank on the arm to make him walk faster.

Why does the child suffer from subluxation of radial head?

The elbow joint is composed of the upper end of the ulna and radius and the lower end of the humerus. The radial head is wrapped and fixed by the surrounding synovium and annular ligaments to prevent the radial head from escaping from its proper position.

Due to the incomplete development of children’s radial head and weak annular ligament, subluxation of radial head is easy to occur, especially in children under 5 years old.

Take the sudden pull-up as an example, Because children’s annular ligaments are weak, When the child’s hand is suddenly pulled up, The negative pressure in the elbow joint capsule will increase, The tissue around the radial head (such as annular ligament) will [run] between the humeral head and the radial head. As a result, after the [pull] action disappears, the radial head cannot return to its original position, which forms the subluxation of the radial head. As shown in the following figure, the tissue originally around the radial head (Fig. 1), after the elbow joint is pulled (Fig. 2), the surrounding tissue squeezes between the humeral capitulum and the radial head (Fig. 3).

How should subluxation of radial head be treated?

In general, The diagnosis of radial head subluxation is not difficult, There is a definite history of traction injury, the child’s elbow pain, crying, the injured side cannot lift or take things, the radial head has tenderness and so on can be diagnosed. Normally, radial head subluxation is normal under X-ray, but if the doctor thinks the child may have more serious injury, X-ray is still needed.

Once the radial head subluxation is diagnosed:

1. Manipulation reduction

Under normal circumstances, subluxation of radial head does not require surgery, only manual reduction is required. After a few minutes of successful reduction, the child’s pain will be relieved and crying will be stopped. The affected side can also do such actions as raising hands, touching ears and lifting.

2. No need to fix

If you seek medical treatment immediately after dislocation, you generally do not need fixation.

However, if the doctor does not see a doctor until hours or even days after dislocation, the doctor may fix the injured side to ensure that he will not be injured again.

3. Pay attention to prevent recurrence

Children who have suffered from subluxation of radial head are prone to recurrence. The younger the age, the greater the chance of recurrence.

However, recurrence does not have much influence on the child’s future development, because after the age of 5, the radial head and annular ligament are well developed, and recurrence is not easy.

Can subluxation of radial head be prevented?

Of course. Prevention is always better than treatment. How can we prevent subluxation of radial head?

In a nutshell, don’t yank, don’t yank wildly, just be gentle ~

In addition to [human flesh swing], it is also dangerous to use supermarket shopping carts as [children’s cars]. For more details, click here: Danger! Don’t use supermarket shopping carts as children’s carts