Pulled elbow

Age 1-4

Clinical features

The child not using the affected limb

Elbow in extension and the forearm in pronation

The pain only on elbow movement

No  swelling, deformity, or bruising of the elbow or wrist

On palpation, tenderness is usually absent (remember the clavicle)

Investigations

Clinical diagnosis

Management

Offer analgesia- Panadol

Gain a child’s confidence/ make the child sit in parents lap

Perform reduction manoeuvre

If reduction fails then send to ED

Steps of reduction

1- Make child sit in parents lap

2- Apply pressure over the radial head

3- Fully pronate forearm and then flex the elbow