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Published on: October 10, 2020
Pulled elbow in children: a case series including 66 patients
Adnan Sevencan1, Ümit Aygün, Ulukan İnan
1aDepartment of Orthopaedics and Traumatology, Faculty of Medicine, Eskişehir Osmangazi University, Eskişehir bİzzet Baysal State Hospital, Clinics of Orthopaedics and Traumatology, Bolu, Turkey.
Insights
This study on pediatric pulled elbow found that younger children had more atypical injury histories. Early hospital admission and the supination-flexion maneuver improved successful reduction rates for this common pediatric injury.
Area of Science:
- Pediatric Orthopedics
- Musculoskeletal Injuries
- Pediatric Emergency Medicine
Background:
- Pulled elbow, also known as radial head subluxation, is a common injury in young children.
- Understanding injury patterns and effective treatment is crucial for pediatric care.
Purpose of the Study:
- To analyze the clinical data of 66 children diagnosed with pulled elbow.
- To identify risk factors, optimal reduction techniques, and outcomes for pediatric pulled elbow.
Main Methods:
- Retrospective case series analysis of 66 children with pulled elbow.
- Data collection included patient demographics, injury circumstances, treatment, and follow-up.
- Statistical analysis to determine correlations between variables and outcomes.
Main Results:
- The most common injury time was 12 PM - 6 PM, with spring as the peak season.
- Children under 2 years old showed a higher incidence of atypical injury histories.
- A 86.4% first-attempt success rate was achieved using the supination and flexion maneuver, with earlier hospital admission improving success rates.
Conclusions:
- The supination and flexion maneuver is highly effective for reducing pulled elbow in children.
- Early intervention and appropriate diagnostic algorithms can optimize patient outcomes.
- While generally resolving fully, recurrence of pulled elbow is possible and requires monitoring.
Abstract:
The aim of this case series was to assess the data of 66 children (mean age 28 months) with a diagnosis of pulled elbow. The most common time interval of injury was 12-6 p.m. and spring was the peak season. Children younger than 2 years of age had a higher rate of atypical injury history. A successful reduction by supination and flexion maneuver was achieved at the first attempt in 57 of 66 patients. The patients admitted to the hospital within the first 2 h following the injury had a higher rate of successful reduction at the first attempt. The rate of radiographic examination was considerably high and a well-defined algorithm to avoid the complicacy in ordering a plain radiograph in such cases was suggested. All patients achieved full clinical recovery after a mean follow-up of 2 years, and recurrence was observed in 16 of 66 children.
