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Examination of Pediatric Elbow
Published in Nirmal Raj Gopinathan, Clinical Orthopedic Examination of a Child, 2021
Karthick Rangasamy, Nirmal Raj Gopinathan, Pebam Sudesh
Age. The age of the child is very important. A pulled elbow or “nursemaid’s elbow” occurs mostly due to longitudinal traction of the forearm. It is common between the age of 1–4 years9 and rarely occurs after 5 years due to the development of the orbicular ligament. Supracondylar humerus fractures are common in the age group of 5–8 years. Distal humerus physeal separation is commonly seen in an age of less than 2 years and may be mistaken for elbow dislocation due to the cartilaginous nature of the distal humerus and not being visualized in radiographs.
Pediatric Orthopedic Trauma: Upper Extremity Fractures
Published in David E. Wesson, Bindi Naik-Mathuria, Pediatric Trauma, 2017
Vinitha R. Shenava, Megan M. May
Nursemaid elbow is also known as a “pulled elbow.” This injury results from longitudinal traction on the arm that results in subluxation of the radial head (Figure 20.3.17). It is estimated to occur in 15%–27% of all elbow injuries in children younger than 10 years old [24] and the typical age of injury is 2–4 years of age. The injury results from longitudinal traction with the forearm in pronation. This results in a partial tear of the annular ligament, which then becomes interposed between the radial head and capitellum. This typically occurs when a parent grabs the child’s arm to prevent the child from walking out into traffic or to help the child climb up a step. The child will keep the elbow flexed and the forearm pronated. The subluxation is reduced by supinating the forearm with the elbow in 60°–90° of flexion and then maximally flexing the elbow while applying digital pressure over the radial head. One is usually able to palpate a reduction of the radial head. Following the reduction most children will resume use of the arm. Occasionally, in cases in which children do not resume use of the arm, it is reasonable to apply a long arm splint for a week.
Musculoskeletal Trauma in Infants and Children: Accidental or Inflicted?
Published in B. G. Brogdon, Tor Shwayder, Jamie Elifritz, Child Abuse and Its Mimics in Skin and Bone, 2012
B. G. Brogdon, Tor Shwayder, Jamie Elifritz
So-called nursemaid’s elbow is a partial anterior subluxation of the radial head, commonly seen in infants and children up to age 4. It results from pulling upon or lifting the child by an extended arm. Episodes may be as innocent as pulling an arm through a sleeve or assisting the child to turn over.33 It is easily diagnosed upon physical examination and rarely requires imaging (ultrasonography will do nicely). It is not indicative of child abuse.
How general pediatricians learn procedures: implications for training and practice
Published in Medical Education Online, 2021
Maya S. Iyer, David P. Way, Daniel J. Schumacher, Charmaine B. Lo, Laurel K. Leslie
Nearly 10% of participants described having little experience in performing the 13 required ACGME procedures, aside from umbilical catheter placements and lumbar punctures. More than 50% of the participants said they never gave immunizations, placed a temporary splint, or inserted a peripheral IV during training. None of the participants reduced a dislocation other than a nursemaid’s elbow. Table 3 shows the number of GPeds who had limited experience for each required procedure with quotations that highlight their lack of experience in learning these skills.