Radial head subluxation
Revision as of 18:37, 29 September 2014 by Rossdonaldson1 (talk | contribs)
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
Differential Diagnosis
Elbow Diagnoses
Radiograph-Positive
- Distal humerus fracture
- Radial head fracture
- Capitellum fracture
- Olecranon fracture
- Elbow dislocation
Radiograph-Negative
- Biceps tendon rupture/dislocation
- Lateral epicondylitis
- Medial epicondylitis
- Olecranon bursitis (nonseptic)
- Pronator teres syndrome
- Septic bursitis
Pediatric
- Nursemaid's elbow
- Supracondylar fracture
- Lateral epicondyle fracture
- Medial epicondyle fracture
- Olecranon fracture
- Radial head fracture
- Salter-Harris fractures
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
See Also
Source
Tintinalli