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Understanding the recurrent pulled elbow

Ugur Bezirgan1, Göksel Vatansever2, Yener Yoğun1

  • 1Hand Surgery Unit, Orthopedics and Traumatology Department, Ankara University Faculty of Medicine.

Journal of Pediatric Orthopedics. Part B
|January 23, 2024
PubMed

Insights

Joint hyperlaxity, not bone anatomy, is linked to recurrent nursemaid elbow dislocations in children. This finding helps understand the causes of repeated radial head subluxation.

Area of Science:

  • Pediatric Orthopedics
  • Radiology
  • Clinical Epidemiology

Background:

  • Nursemaid elbow, a common pediatric injury, involves radial head subluxation.
  • The exact causes of recurrent dislocations and the influence of patient-specific factors remain unclear.

Purpose of the Study:

  • To investigate the epidemiology of recurrent nursemaid elbow dislocations.
  • To assess the impact of joint hyperlaxity and bone anatomy on recurrent injuries.

Main Methods:

  • Retrospective study of 329 pediatric patients diagnosed with nursemaid elbow.
  • Radiographic measurement of the radius head-neck ratio.
  • Evaluation of joint hyperlaxity using the Beighton score in patients with recurrent dislocations.

Main Results:

  • A significant association was found between Beighton scores and the number of dislocations in cases of multiple dislocations (P=0.002).
  • No significant relationship was identified between the number of dislocations and the lateral radius head/neck ratio (P=0.061).

Conclusions:

  • Joint hyperlaxity syndrome is a key factor in the etiology of recurrent nursemaid elbow dislocations.
  • Bone anatomy, specifically the radius head-neck ratio, does not appear to be a significant predictor of recurrent dislocations.

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