Overview
What is radial head subluxation?
How is radial head subluxation diagnosed?
What is included in the evaluation of radial head subluxation?
What anatomy is relevant to radial head subluxation?
What is the prognosis of radial head subluxation?
Periprocedural Care
What is included in patient education about radial head subluxation?
Which clinical history and physical findings are characteristic of radial head subluxation?
What is the role of anesthesia in the reduction of a radial head subluxation?
How is the patient positioned for reduction of a radial head subluxation?
Technique
What are the methods used for reduction of a radial head subluxation?
How is supination-flexion reduction of a radial head subluxation performed?
How is hyperpronation/forced pronation reduction of a radial head subluxation performed?
What is included in postprocedural care of a radial head subluxation?
Medications
What is the goal of drug treatment for radial head subluxation?
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Subluxation of radial head occurs after longitudinal traction is placed on pronated extended arm.
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In radial head subluxation, subluxated arm is held semiflexed, adducted, and pronated.
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Alternative diagnoses to radial head subluxation should be sought if point tenderness or any obvious deformity is present.
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Reduction of subluxated radial head: supination-flexion. Technique begins with elbow flexed.
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Reduction of subluxated radial head. Shortly after reduction, child resumes using affected arm.
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Reduction of subluxated radial head: supination-flexion. Wrist is supinated with elbow still in 90° of flexion.
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Reduction of subluxated radial head: supination-flexion. During supination, pressure is maintained on radial head.
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Reduction of subluxated radial head: supination-flexion. After supination, elbow is fully flexed.
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Reduction of subluxated radial head: supination-flexion. With one hand supinating wrist, other thumb feels click as radial head falls into place on full flexion.
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Reduction of subluxated radial head: supination-flexion. Technique begins with supination, followed by full flexion at elbow.
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Reduction of subluxated radial head: hyperpronation/forced pronation. With one hand placed distally, arm is hyperpronated while other hand holds elbow steady with thumb on radial head.
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Shortly after reduction, child resumes using affected arm.
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Reduction of subluxated radial head: supination-flexion. Side view of technique.
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Reduction of subluxated radial head: supination-flexion. Front view of technique.
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Reduction of subluxated radial head: hyperpronation/forced pronation. Side view of technique.
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Reduction of subluxated radial head: hyperpronation/forced pronation. Front view of technique.
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Elbow anatomy with annular ligament.