What are the other Names for this Condition? (Also known as/Synonyms)

• Babysitter’s Elbow
• Nursemaid Elbow
• Radial Annular Ligament Displacement

What is Radial Head Subluxation? (Definition/Background Information)

• Radial Head Subluxation is a common childhood injury that is characterized by the partial dislocation of the elbow due to the radius, a bone in the forearm, being pulled away from its normal position
• Children have tendons and ligaments that are still developing; so, it takes very little strength to pull the joints out of place. A Radial Head Subluxation may occur by swinging a child by his/her arms, pulling their arms with a brute force, or by activities involving such motions
• The radius is one of the bones that form the forearm, stretching from the wrist to the elbow. The radial head is one end of the radius, near the elbow. The annular ligament keeps the radial head in its position within the elbow joint
• As the child gets older, the ligament gets stronger. Generally, the ligament does not get damaged or injured. However, sometimes, even a minor force can cause Radial Head Subluxation. Children with the injury can experience severe pain and may not move their injured arm or shoulder
• A healthcare provider can diagnose the condition through a physical examination. Radial Head Subluxation may be treated through a reduction technique in which the bones are placed back into position by a qualified healthcare provider. Typically, the prognosis for Radial Head Subluxation is excellent with proper treatment

Who gets Radial Head Subluxation? (Age and Sex Distribution)

• Radial Head Subluxation can occur in any child between the ages of 6 months to 7 years. Generally, the condition is more prevalent in children between the ages of 2-3 years
• Both boys and girls are affected, but a higher incidence rate is seen among girls
• Children of different racial and ethnic backgrounds may be affected

What are the Risk Factors for Radial Head Subluxation? (Predisposing Factors)

The risk factors for Radial Head Subluxation may include:

• Swinging or pulling a child by his/her arms or hands
• Physically abusing a child

It is important to note that having a risk factor does not mean that one will get the condition. A risk factor increases one's chances of getting a condition compared to an individual without the risk factors. Some risk factors are more important than others.

Also, not having a risk factor does not mean that an individual will not get the condition. It is always important to discuss the effect of risk factors with your healthcare provider.

What are the Causes of Radial Head Subluxation? (Etiology)

Radial Head Subluxation is a common elbow injury that is caused when the radius, a bone in the forearm, is pulled out of position by actions such as:

• A parent or caregiver pulling or suddenly jerking on the child's arm to help them move or avoid a potentially dangerous situation
• Inadvertently swinging the child by their arms or hands while playing
• Abnormal stress on the radial head bone may occur during physical activities (playing) such as rolling over in an awkward way
• Child abuse that may be intentional

Due to a sudden and sometimes violent action, the radial head slips out of position of the elbow joint.

What are the Signs and Symptoms of Radial Head Subluxation?

Signs and symptoms of Radial Head Subluxation may vary between children and it may include:

• Pain in the arms or shoulder area when movement is induced
• A child may hold the arm still by their side and refuse to move it; joint movement restriction
• Swollen arm
• For some reason, the incidence rate is slightly more in the left arm than the right arm

The incidence of Radial Head Subluxation decreases as a child gets older.

How is Radial Head Subluxation Diagnosed?

A healthcare professional can diagnose Radial Head Subluxation through:

• A thorough analysis of previous medical history along with a physical examination, which is important
• X-ray scan of the elbow to rule out a fracture or broken bones
• If Radial Head Subluxation occurs repeatedly, then MRI studies of the elbow may be required

Many clinical conditions may have similar signs and symptoms. Your healthcare provider may perform additional tests to rule out other clinical conditions to arrive at a definitive diagnosis.

What are the possible Complications of Radial Head Subluxation?

Complications of Radial Head Subluxation may include the following:

• Severe pain and agony for the child
• Troubles with daily activities and movement
• Recurrence of the condition, in rare cases

How is Radial Head Subluxation Treated?

Treatment of Radial Head Subluxation may include:

• Reduction: It is a method of placing the bones back into place in the joint. A pop sound may be heard when the radius is put back into its normal place by a healthcare provider. In some rare cases, a manual manipulation of the affected joint may not be able to rectify the defect
• If Radial Head Subluxation occurs frequently even as the child gets older, the healthcare provider may use surgical methods to tighten the annular ligament
• Conservative measures may be used to address pain and inflammation

How can Radial Head Subluxation be Prevented?

Radial Head Subluxation can be prevented by ensuring the following:

• Safely lifting a child by holding them from under their armpits and not by their arms or hands
• Do not swing or pull violently on a child's arms or hands

What is the Prognosis of Radial Head Subluxation? (Outcomes/Resolutions)

• The prognosis for Radial Head Subluxation is usually excellent with appropriate treatment as the condition can be easily treated or corrected
• The child can use the affected arm immediately after correction to fix the arm

Additional and Relevant Useful Information for Radial Head Subluxation:

• Forearm fractures in children are breaks or cracks that may occur near the lower part of the forearm near the wrist (distal region), the center of the forearm, or at the upper part of the forearm near the elbow (proximal region)

The following link may provide useful information on forearm fractures in children:

http://www.dovemed.com/diseases-conditions/forearm-fracture-in-children/