2. Pulled Elbow Nursemaid‘s Elbow
SUBLUXATION OF THE RADIAL HEAD

3. Case - 1
6 month -3 year old child brought with inability to move the hand
sometimes pain in the shoulder
history of pull of the hand while walking
sometimes spontaneous
can be recurrent
irritable & inability to move hand

4. Assessment Evaluate for tenderness or swelling
Filling of dimples of the olecranon
Do not reduce

5. Reduction Explain to parents that it may be briefly painful
Distract the baby
Gentle traction followed by either hyper-pronate or if it fails hyper-supinate and flex
Feel for the click
Allow the baby to rest and check movement
If it fails ; posterior slab and Orthopedics consultation