Dislocations of the upper extremity in children

Area of Science:

• Pediatric Orthopedics
• Trauma Surgery
• Pediatric Sports Medicine

Background:

• Traumatic dislocations and subluxations of the upper extremity are relatively uncommon in pediatric patients.
• The elbow joint is the most frequently dislocated joint in children, occurring more often than in adults.
• Severe neurovascular compromise can be a complication of pediatric elbow dislocations.

Purpose of the Study:

• To survey traumatic dislocations and subluxations of the upper extremity in children.
• To identify the most common sites and mechanisms of these injuries.
• To outline principles of management based on pediatric anatomy.

Main Methods:

• Review of pediatric upper extremity traumatic dislocations and subluxations.
• Analysis of injury patterns, including joint involvement and common causes.
• Correlation of anatomical features with injury mechanisms and management strategies.

Main Results:

• Elbow joint dislocations are the most common upper extremity dislocations in children.
• Radial head subluxation, often termed "pulled elbow," is the most frequent subluxation.
• The relative weakness of the epiphyseal plate contributes to the lower incidence of dislocations and subluxations in children compared to adults, with most injuries resulting from indirect forces.

Conclusions:

• Pediatric upper extremity dislocations and subluxations, while less common than in adults, predominantly affect the elbow.
• Understanding the unique pediatric anatomy, particularly epiphyseal plate vulnerability, is crucial for diagnosis and management.
• Effective treatment relies on principles of reduction and immobilization adapted to the specific joint and injury patterns.