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A Standardized Method for Measurement of Elbow Kinesthesia
Published on: October 10, 2020
Investigation on 2331 cases of pulled elbow over the last 10 years
Takashi Irie1, Takashi Sono1, Yousuke Hayama2
1Department of Orthopedic Surgery, Kurashiki Central Hospital , Kurashiki, Japan.
Insights
Pulled elbow, a common pediatric injury, frequently affects the left arm due to forcible traction. Most children recover within two weeks, though recurrence rates are around 14%.
Area of Science:
- Pediatric Orthopedics
- Musculoskeletal Injuries
- Childhood Trauma
Background:
- Pulled elbow (also known as nursemaid's elbow) is a frequent upper extremity injury in children.
- This condition involves the subluxation of the radial head from the annular ligament.
- Understanding its epidemiology and risk factors is crucial for prevention and management.
Purpose of the Study:
- To retrospectively analyze a decade of pulled elbow cases in pediatric patients.
- To identify demographic, injury, and treatment outcome patterns.
- To investigate factors influencing the affected arm and recurrence.
Main Methods:
- Retrospective review of 2331 pulled elbow cases from January 2002 to December 2011.
- Data collected included sex, age, affected arm, recurrence, injury mechanism, and treatment outcomes.
- Statistical analysis was performed to identify trends and significant differences.
Main Results:
- No significant sex difference in pulled elbow incidence.
- Injury frequency peaked between 6 months and 2 years of age.
- The left arm was more frequently affected (14% recurrence rate), with injury often caused by forcible forearm traction.
- Younger children (<1 year) sustained injuries from rolling over; older children showed increased left arm injury frequency with age.
Conclusions:
- Pulled elbow incidence shows no sex predilection but peaks in toddlerhood.
- Forcible traction is a primary cause, with a notable tendency for left arm involvement in older children.
- While generally resolving quickly, vigilance for associated fractures is warranted.
Abstract:
Pulled elbow is a common upper extremity injury in children. We present a retrospective study of 2331 pulled elbow cases examined in our hospital over the last ten years. All pediatric patients with a diagnosis of pulled elbow from January 2002 to December 2011 were retrospectively reviewed according to sex, age, affected arm, recurrence rate, mechanism of injury and treatment outcomes. There is no significant sex difference. The frequency of injury peaked for both boys and girls at 6 months and 2 years of age. The left arm was more affected than the right. The recurrence rate was 14%. In about 50% of cases, the cause of injury was forcible traction to the forearm. Almost all of the splinted patients, caused by severe pain or lack of mobility of the affected limb following reduction, recovered within 2 weeks, but 2 were later diagnosed with a fracture. For infants less than 1 year old, injury can often occur when rolling over. For children 1 year old or older the left arm is more commonly affected, and the frequency of injuries to the left arm increases with age, possibly because the left hand is commonly held by the guardian's dominant right hand and faster development of muscle strength in the child's dominant right arm works toward preventing injury to that arm with age.
