1. PULLED ELBOW
IN CHILDREN

2. HISTORY
• USUALLY IN CHILDREN 1-4 YEARS
OLD
• RADIAL HEAD SUBLUXES
• DISTINCT HISTORY OF A ‘PULL’
• ANY Hx OF A FALL CONSIDER
SUPRACONDULAR FRACTURE

3. SIGNS AND SYMPTOMS
• RELUCTANCE TO USE ARM
• WILL NOT STRAIGHTEN
• CLEAR Hx OF A ‘PULL’
• NOT ALWAYS SWOLLEN OR
DEFORMED
• CHECK RADIAL PULSE BEFORE AND
AFTER

4. TECHNIQUE
• apply pressure over the radial head

5. • supinate the forearm

6. • flex the elbow

7. POST MANIPULATION
• ASSES USE 10 MINS AFTER
• GIVE ANALGESIA PRN
• LOW THRESHOLD TO RETURN IF NOT
USING LIMB
• CHECK RADIAL PULSE
• RE SUBLUXATION IN 30% OF
CHILDREN WITHIN 3 MONTHS

8. REFERENCES
• ROYAL CHILDENS HOSPITAL
MELBOURNE, CLINICAL GUIDELINES.
• http://www.rch.org.au/clinicalguide/cpg.cfm?do