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Radial Head Subluxation (Pulled Elbow)

The elbow is a joint composed of three bones held in place by strong ligaments (bands of tissue). One ligament is looser in young children than in adults. As a result, soft tissue may become trapped between the bones in a child's elbow joint. The medical name for this injury is radial head subluxation. It usually occurs when a child is lifted or pulled by one arm.

Rear view of bent elbow showing radius and ulna connected to humerus with ligaments. Radial head subluxation occurs when ligament in elbow becomes trapped between head of radius and humerus.

Risk Factors

Children under age 4 are most likely to have a radial head subluxation. As children grow older, their elbow ligaments become stronger. For that reason, this injury rarely occurs after age 6.

When to Go to the Emergency Room (ER)

A radial head subluxation causes sudden pain. In addition, your child won't be able to flex his or her elbow. The injured arm is likely to hang loosely at your child's side. If your doctor can't see the child right away, go to the nearest emergency department.

Preventing a Pulled Elbow

These tips can help prevent radial head subluxation in a child:

  • Lift your child under the arms—not by the hands or wrists.

  • Don`t swing your child by the arms.

  • Don`t pull your child by the hand or arm, even when you`re in a hurry.

What to Expect in the ER

A doctor will examine the injured arm. An x-ray may be taken. The doctor will then gently move the joint to release the trapped tissue. Your child can sit on your lap facing the doctor while this is done. It's likely to hurt for just a minute. Your child will be fine once the parts of the joint are all back in place. Most often, no other care is needed.

 

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