[Medical Q&A] Why did my child suddenly start crying because his arm hurt when I was leading him to climb the stairs?

Planner: Chinese Medical Association

Reviewer: Shao Zengwu, Chief Physician and Professor of Union Hospital affiliated to Tongji Medical College, Huazhong University of Science and Technology

In this case, radial head subluxation should be highly suspected.

Radial head subluxation is a disease caused by the imperfect development of the radial head. When the wrist or arm is pulled upward and rotated, the weak annular ligament or part of the joint capsule tissue is embedded between the capitulum of the humerus and the radial head. After the traction force is removed, the tissue is incarcerated, resulting in the inability of the radial head to be repositioned. This disease is a common elbow injury in young children. It is common in children aged 1 to 5 years old, more common in boys than in girls. It can occur on both sides, but slightly more on the left side. It is most common when adults lead children up the stairs and pull the children's wrists or arms. The typical symptoms are that after the pulling action occurs, the child cries and has elbow pain, the elbow remains in a semi-flexed and pronated state, refuses to lift or move the affected limb, and dares not flex the elbow.

The treatment of radial head subluxation mainly relies on manual reduction, without anesthesia and traction. The forearm is rotated from extension to flexion of the elbow joint. The sign of successful reduction is a slight bounce feeling at the humeroradial joint. After reduction, the elbow and forearm can move freely, local pain is significantly reduced, and the child can immediately grasp the toy and raise the forearm without obstacles. After reduction, the forearm can be suspended with a triangular bandage for 5 days without plaster fixation.