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Pulled elbow

What is a pulled elbow?

A pulled elbow is a common childhood injury. It results from a slight movement of the radius, which is a bone in the forearm. Usually there is a strong, stretchy band called a ligament that holds the radius bone in place, but after an injury the ligament can be overstretched and the bone can slip out. It usually occurs in 2 to 4 year olds. However, it can occur at any age from 8 months to 8 years. It is not a dislocated elbow.

How does it happen?

It typically occurs when a child’s arm is suddenly pulled. For example, if a child falls whilst holding a parent’s hand, sustaining a forceful upwards tug on the arm. Other common situations are toddlers who grab something for support while falling, or get pulled when playing with an older sibling.

What are the symptoms?

The affected arm usually hangs limply. Children often play happily, but without using the affected arm at all.

What treatment is necessary?

Usually a simple manipulation will move the radius back into place. An X-ray is not necessary to diagnose a pulled elbow. If the manipulation works the elbow will be completely normal again after a few minutes. Your child will be observed to check that they are using their arm without problems or pain. There is no need to wear a sling or bandage.

Occasionally a pulled elbow can be more difficult to put back into place, or your child might still not be using the injured arm. In this situation we may consider an X-ray to check for other possible injuries such as a fracture. If there is no fracture but your child is still not using the injured arm you will be given a clinic appointment in 2 to 3 days to check that this has settled. Often the radius will move back into place by itself during this time, for example whilst the child is getting dressed.

Will it happen again?

Some children will be prone to a pulled elbow again, but they do grow out of this type of injury as the elbow develops with age, usually around the age of 6 to 7 years.

To prevent a pulled elbow, lift them up using their armpits rather than their lower arms or wrists.

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Please note: this is a generic information sheet relating to care at Sheffield Children’s NHS FT. These details may not reflect treatment at other hospitals. This information is not intended as a substitute for professional medical care. Always follow your healthcare professionals’ instructions. If this resource relates to medicines, please read it alongside the medicine manufacturer’s patient information leaflet. If this information has been translated into another language from English, efforts have been made to maintain accuracy, but there may still be some translation errors. If you are unsure about any of the guidance in this resource or have specific questions about how it relates to your child, always ask your healthcare professional for further advice.

Resource number: ED43

Resource Type: Article

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