Outcomes of Pulled Elbow in the Children: An Original Article

Abstract

Saccomanni Bernardino

Introduction: Radial head subluxation [RHS] or Pulled Elbow is a common disorder in children. Although it is not accompanied by any important short- or long-term sequel, it could make the parents worried about.

Objective or purpose: The purpose of this study was to determine the possible effective factors that may influence time to use the affected limb.

Methods: This cross-sectional study was conducted prospectively during the years 2014 to 2016. All children under the age of 6 years who visited the emergency department [ED] and were diagnosed as having RHS were eligible. The patients’ baseline information was recorded. After the reduction, the time until the affected arm use returned was recorded. The possible relationship between the baseline data and time to re-use the affected limb was assessed.

Results: During the study period, 112 children with a mean age of 30.18 ± 18.18 months were evaluated [53% male]. Among the children who visited the ED during the first 4 hours and thereafter, 84% and 60%, respectively, re-used their limb in less than 10 minutes after reduction [p = 0.004]. Also, 55% of children less than or equal to 24 months and 89% over the age of 24 months re-used the arm in 10 minutes [p < 0.001]. The success rate of the first reduction maneuver was significantly lower in children with a recurrent dislocation [p = 0.001].

Conclusion: It is likely that age less than or equal to 24 months and ED visit after 4 hours of the event lead to a longer duration for re-using the affected arm following reduction.

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