When
your baby comes back from playing and suddenly starts crying uncontrollably,
with their little arms limp and unwilling to be touched, many parents' first
reaction is, "Oh no! Is it a fracture?" In fact, you may have
encountered a more common "invisible assassin" - radial head
subluxation!
Director Wang Kuai-sheng of the Orthopedics Department at Hainan Chengmei Hospital reminds that "subluxation of the radial head", commonly known as "tension elbow", is highly prevalent among children. Children under the age of 5 are particularly vulnerable to this condition, so parents must be vigilant!
Why are children prone to radial head subluxation?
Director Wang Kuai-sheng explained that in children under 5 years old, the radial head is not fully ossified, and its shape tends to be oval, with low matching degree with the joint socket; the annular ligament that wraps and fixes it is weak and loose, making it difficult to stabilize the joint. When the elbow joint is straightened, if the arm is suddenly pulled longitudinally, the radial head is prone to slipping off the annular ligament, causing subluxation.
Director Wang Kuaisheng emphasized that over 90% of cases have clear pulling triggers, such as a child suddenly breaking free when holding hands, violently lifting the arm, forcibly tugging at the sleeve, or rotating the arm. Among them, the incidence rate is highest in children aged 2-3 (over 60%), and it significantly decreases after the age of 5 as the radial head and annular ligament mature.
Parents should be vigilant about these typical symptoms
Young children often struggle to articulate their pain, but parents can quickly identify it through typical symptoms.
Firstly, there is a clear history of traction, and symptoms appear immediately;
Secondly, sudden crying occurs, accompanied by pain on the lateral side of the elbow, and the crying intensifies when the affected limb is touched or moved;
Thirdly, the affected limb hangs naturally, with the elbow slightly flexed and the palm facing downwards, and the patient refuses to move actively;
Fourthly, there is no redness, swelling, or deformity at the elbow, and the appearance is close to that of a normal arm, which is a key difference from complete dislocation.
Director Wang Kuaisheng reminds that many parents mistakenly judge the condition as a common strain due to the absence of redness and swelling at the elbow, thus delaying treatment. If the aforementioned symptoms occur, it can be preliminarily diagnosed as radial head subluxation. There is no need to wait or apply massage; immediate medical attention is required. Delayed reduction may lead to joint edema and adhesion, increasing the difficulty of reduction and potentially affecting arm function.
By doing so, we can safeguard the joint health of children
Director Wang Kuaisheng reminds parents: Do not attempt to reset on your own! Non-professional operations may aggravate ligament damage and even injure the radial nerve, leading to numbness in the fingers and limited mobility. The correct approach is to immediately take the child to the orthopedic department. The doctor can quickly reset the injury using the "supination and flexion elbow method", which causes minimal pain. Most children can actively move their fingers 10-30 minutes after the reset.
Post-reduction care is equally important. Director Wang Kuaisheng suggests that after the initial dislocation, the affected limb should be suspended in front of the chest with a triangular bandage, keeping the elbow flexed at 90°, for 3-5 days to avoid traction. For patients with recurrent dislocations, fixation for 1-2 weeks is necessary to strengthen ligament stability.
Prevention is key, and parents need to:
When carrying a child, prioritize supporting the elbow and avoid jerking the wrist;
Second, wear loose clothing and gently put it on and off without forcefully pulling;
Third, avoid dangerous actions such as twirling by holding the baby's arms or swinging on a swing. When carrying the baby, support their armpits and hips.
Director Wang Kuaisheng emphasized that although radial head subluxation is common, standardized nursing practices and risk avoidance can significantly reduce its incidence. If a child exhibits suspicious symptoms, it is imperative to seek medical attention at a reputable orthopedic hospital without delay, and one should never rely on luck.
Expert Introduction
Wang KuaiSheng, Chief Physician
Director of Orthopedics
High-level talents in Hainan Province
Medical expertise
Skilled in the diagnosis and treatment of orthopedic-related diseases such as hand injuries, congenital hand deformities, nerve injuries, vascular injuries, tendon injuries, wrist diseases, peripheral nerve diseases, osteoarthritis, and lumbar diseases; possesses extensive clinical experience in the diagnosis and treatment of trauma diseases such as limb trauma and limb fractures. Skilled in microsurgical techniques, capable of proficiently performing orthopedic microsurgical repair surgeries related to microsurgery, including nerve, vascular, and tendon injury repair, skin flap repair, scar plastic surgery, etc.
Article | Huang Fei