Pulled Elbow

What is a pulled elbow?

It is a common minor injury, which usually occurs in children under 6 years of age. The injury occurs when the forearm bone, the radius bone, slips out of the encircling ligament at the elbow. This ligament usually holds the radius and its neighbouring bone, the ulna, in place.

What causes a pulled elbow?

Young children are more prone to this injury as their bones and joints have not fully developed and are more rounded. In addition, their ligaments are softer. Therefore simple pulling forces can result in a pulled elbow.

Common ways this can happen:

• Lifting your child by their hands
• Pulling your child’s arm through a sleeve on dressing
• Your child sharply tugging away from you when holding their hand
• Pulling your child sharply to prevent them from falling when holding their hand
• Playful swinging

Sometimes it is not clear what has caused the problem.

What are the signs and symptoms of a pulled elbow?

• The affected limb hangs limply by your child’s side
• Your child holds their forearm against their tummy
• Your child avoids using their affected hand/arm
• Inconsolable crying on using/moving the affected arm
• A popping sound may be heard when the injury occurs

How is a pulled elbow diagnosed?

We will take a detailed story of how the injury occurred and examine your child. This will help us to determine whether there is any other cause for your child’s symptoms.

X-rays would only be needed if a more serious injury is expected as they do not show ligaments.

Treatment of a pulled elbow?

• We will give your child some simple pain relief medication if they are in discomfort
• We will perform a simple arm movement with the intention of relocating the head of the radius into its correct position. Your child may experience some discomfort at this time but the manoeuvre only takes seconds to perform
• We usually observe your child in the department to make sure that they start to use the arm as normal

Sometimes we cannot be certain if relocation of the radial head has been achieved. In these circumstances we will let your child go home with a collar and cuff sling, as this sometimes helps to relocate the bone naturally, and we will see them in our clinic after a few days.

Returning to normal function?

Your child should be able to return to normal function within a few days. If you are still concerned that your child is not using their arm we will be happy to see you again in the Children’s Emergency Department.

How can a pulled elbow be prevented?

You should avoid the common causes of pulled elbow which have been discussed previously, for example, lifting your child by their hands.

If you have any problems or concerns please contact the Children’s Emergency Department on: Telephone: (01274) 383187.

Alternatively, attend in person to the Children’s Emergency Department and ask to speak to a member of the nursing staff.