Radial head subluxation: Difference between revisions
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== | ==Background== | ||
*Radial head subluxation due to longitudinal traction on arm | |||
**Annular ligament of radius displaces into radiocapitellar articulation | |||
*Age 1y-5y (peak 2y-3y) | |||
==Diagnosis== | ==Diagnosis== | ||
*Sudden onset | |||
*Absence of edema, focal tenderness, or bruising | |||
**If these features are present, consider x-ray and alternative diagnosis | |||
== | ==Management== | ||
*Reduce | |||
**Hyperpronation Technique | |||
***Hold pt's elbow at 90 degrees with one hand | |||
***With other hand hyperpronate pt's wrist | |||
**Supination Technique | |||
***Hold pt's elbow at 90 degrees with one hand | |||
***With other hand supinate pt's wrist and flex elbow | |||
*If successful pt will have FROM w/in 30min | |||
*If unsuccessful after multiple attempts obtain x-ray | |||
**If negative immoblize arm in sling, outpt ortho f/u w/in 1wk | |||
==Source== | |||
Tintinalli | |||
[[Category:Peds]] | [[Category:Peds]] | ||
[[Category:Ortho]] | [[Category:Ortho]] | ||
Revision as of 21:52, 30 June 2011
Background
- Radial head subluxation due to longitudinal traction on arm
- Annular ligament of radius displaces into radiocapitellar articulation
- Age 1y-5y (peak 2y-3y)
Diagnosis
- Sudden onset
- Absence of edema, focal tenderness, or bruising
- If these features are present, consider x-ray and alternative diagnosis
Management
- Reduce
- Hyperpronation Technique
- Hold pt's elbow at 90 degrees with one hand
- With other hand hyperpronate pt's wrist
- Supination Technique
- Hold pt's elbow at 90 degrees with one hand
- With other hand supinate pt's wrist and flex elbow
- Hyperpronation Technique
- If successful pt will have FROM w/in 30min
- If unsuccessful after multiple attempts obtain x-ray
- If negative immoblize arm in sling, outpt ortho f/u w/in 1wk
Source
Tintinalli