Searchfor:GetStartedSkinDeepDFTBModulesCOVIDQuickRefX-raysBubbleWrapOurConferenceComingUpForAirDFTB:Live+ConnectedDFTBEssentialsDFTB21DFTB19TalksDFTB18TalksDFTB17talksPodcastAboutUsrss_feedtwitter_accountfacebook_accountyoutube_accountemail_toPulledelbowsTessaDavisEmergency/Generalpaediatrics/Orthopaedics/X-rayinterpretationTags:elbow,elbowsprain,nursemaidselbow,pulledelbowCitethisarticleas:TessaDavis.Pulledelbows,Don'tForgettheBubbles,2018.Availableat:https://doi.org/10.31440/DFTB.16407Annieisa2yearoldwhohasapainfularm.Hermumwasholdingherhandasshewalkedalongthepavement.AnnietrippedandAnnie’smumtriedtostopthefall.Sincethenshehasn’tbeenusingthearmasmuch. ThankstoSimonCraigforhispost-publicationcontribution. AnatomyThemedialandlateralcollateralligamentseachholdthehumerusandulnatogether(oneoneitherside).Theannularligamentholdtheradiusandulnatogether.Inapulledelbow,theannularligamentslipsoftheheadoftheradiusandcangettrappedinbetweentheradiusandhumerus.Thiscausesrestrictionofmovementandpainonpronationandsupination.fromWikipedia Ifyouwanttoreviewyouranatomythencheckoutourelbowradiologysection.MechanismThemechanismisusuallyfromapullofthearme.g.whenthechildfalldownwhileholdingtheparent’shandandtheparenttriestostopthemfallingbypullingthearm. PresentationThechildmostcommonlypresentsasnotusingtheirarmandonassessmenthasthearmhanginglimplybytheirside.Whenasked,theymaypointtodistalradiusasthepointofpain,whichcanleadustosuspectabucklefracture. Therewillbepainonpronationandsupination. TechniquesTherearetwomaintechniquestoreduceapulledelbow.Thefirstishyper-pronation.Forthistechniqueapplypressureovertheradialhead,thenhyper-pronatethearm.fromRCHwebsitefromRCHwebsite Thesecondtechniqueissupination-flexion.Againapplypressureovertheradialhead,supinatethearm,andthenflextheelbow(whilethearmisstillsupinated).fromRCHwebsitefromRCHwebsitefromRCHwebsitefromRCHwebsite A2017Cochranereview foundlowqualityevidencethatthehyperpronationtechniquehadabettersuccessrateatfirstattemptreductionthatthesupi