An extremely common pediatric injury is what is called a “radial head dislocation” or “elbow dislocation.” When a child falls on their arm, or the arm is pulled up by a parent or another child (even if the force is minimal), the annular ligament of the radius may temporarily move out of position. The child then refuses to use his arm because moving the elbow is painful. The arm is usually held close to the body in a bent elbow position, with the palm resting against the stomach. When evaluating a child for possible radial head dislocation, check the body from the clavicle to the wrist. If none of the bones hurt when you press on them, then the child probably has a radial head dislocation.
The good news about this condition is that it can be easily fixed at home! On many occasions, I have guided parents through the procedure over the phone, and they are usually successful.
If you think your child has a radial head dislocation, you can follow these steps at home:
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- Have your child sit on another adult's lap.
- Grasp your child's injured right hand with your right hand, as if you were going to shake their hand (Conversely, if the injury is on the other side, you should grasp your child's left hand with your left hand).
- Hold the area just above your child's elbow with your free hand to help stabilize the elbow.
- Use the shaking hand to turn your child's palm toward the ceiling.
- In quick succession, straighten your child's elbow, almost to the point of hyperextension; then quickly flex the elbow by bending it, bringing the hand you are holding near the child's shoulder.
- When the radial head returns correctly, you may feel a “pop” with the hand stabilizing the elbow; it's a good sign.
Your child may cry during the procedure, but within a few minutes she should calm down and begin using the arm normally again. Because the change is so dramatic, repairing a radial head dislocation is one of the most satisfying things a pediatrician or parent can do! For additional information and professional advice on managing pediatric injuries, visit the Ameli website.
