Radial Head Subluxation

　　1. Due to the incomplete development of the radius bone in children under 5 years old, the contour of the radius bone is elliptical, and the lateral posterior part is relatively flat. The annular ligament is just a thin fibrous membrane, loose, and prone to dislocation.

　　2. Commonly seen when young parents hold children's hands while walking on the street, with the children's upper limbs raised and the parents' upper limbs hanging down. When encountering steps, the parents suddenly lift the children's hands or use force to help them dress, which can also cause partial dislocation of the radius bone due to rough traction.

　　3. When the elbow is in pronation and traction, a negative pressure is generated in this joint, causing the annular ligament to become tense, forming a funnel shape, and sliding over the radius bone, making it difficult for the forearm to rotate. When children are walking or dressing, their forearms are pulled longitudinally, and the radius bone slides to the distal end; when restoring to the original position, the upper part of the annular ligament does not retreat sufficiently and gets locked in the humeroradial joint, causing dislocation.

　　1, Median nerve palsy:Early reduction can allow the median nerve to recover completely early. If delayed reduction, recovery may not be complete. But rarely require other treatment.

　　2, Sudeck atrophy:This is a common complication of the disease;

　　3, Ischemic necrosis:It can lead to lunate collapse and secondary osteoarthritis, the latter progresses very quickly. All patients with lunate dislocation should have X-ray re-examination every month within 6 months after the injury to detect this complication in time. If detected early, the lunate can be excised to prevent the occurrence of progressive osteoarthritis. For many cases, of course, it is late-stage patients. Tend to perform wrist joint fixation surgery. Note, repeated injury to the wrist without lunate dislocation can also have similar X-ray manifestations (Kienbock's disease). It is more common in physical laborers, such as carpenters, shoemakers, and those who frequently use hammers.

　　1, There is a history of upper limb traction. Usually young parents hold children on the street, the child's upper limb is raised, the parent's upper limb is hanging down, when encountering steps, the parent's hand suddenly pulls the child's hand to help the child cross the steps, and symptoms appear immediately afterwards, or force the child to wear a woolen sweater, rough traction force can also cause radial head subluxation.

　　2, Children complain of pain in the elbow and are unwilling to pick up objects with that hand or move the elbow, and refuse to be touched by others.

　　3, The signs found during the examination are very few, without swelling and deformity, the elbow joint is slightly flexed, and there is tenderness at the radial head.

　　4, X-ray examination is negative.

　　1, When pulling (picking up) children's hands, the sleeves should be pulled at the same time.

　　2, Prevent falls.

　　3, When adults and children are playing, attention should be paid to the method, and the hand should not be pulled (pulled) alone.

　　4, Avoid repeated dislocation, forming a habit.

　　5, When putting on clothes, avoid hand pronation traction, and pull the sleeve at the same time.

　　1, There is a history of upper limb traction, usually young parents holding children on the street, the child's upper limb is raised, the parent's upper limb is hanging down, when encountering steps, the parent's hand suddenly pulls the child's hand to help the child cross the steps, and symptoms appear immediately afterwards, or force the child to wear a woolen sweater, rough traction force can also cause radial head subluxation.

　　2, Children complain of pain in the elbow and are unwilling to pick up objects with that hand or move the elbow, and refuse to be touched by others.

　　3, The signs found during the examination are very few, without swelling and deformity, the elbow joint is slightly flexed, and there is tenderness at the radial head.

　　4, X-ray examination is negative.

　　1, Appropriate amount of red bean, decocted and taken, a little red sugar is added to warm it, this recipe is suitable for the stage of activating blood and removing blood stasis.

　　2, Pork bones 1000 grams, soybeans 250 grams, add water and simmer on low heat until soft, season with salt and ginger, and eat as food.

　　3, Pork backbone one set, washed, red dates 120 grams, lotus seeds 90 grams, osmanthus wood, and raw licorice each 9 grams, add water and simmer on low heat until soft, season with ginger and salt, and drink in several doses.

　　4. Two fresh lake crabs, take the meat (with yolk), add the crab meat to the cooked glutinous rice, add a suitable amount of ginger, vinegar, and soy sauce, taken regularly.

　　5. A wry rooster (about 500 grams), skin, feathers, and internal organs removed, washed, 5 grams of Sanqi (notoginseng) sliced, placed in the chicken stomach, add a small amount of yellow wine, steamed in water, served with soy sauce after cooking, taken regularly.

　　6. Raw Huangqi 30-60 grams, decocted to a concentrated juice, add 100 grams of粳米 (glutinous rice), cooked into porridge, taken in the morning and evening.

　　7. Danggui 20 grams, Huangqi (Astragalus membranaceus) 100 grams, a young hen, boiled in water for soup and eaten.

　　8. Zishen (Salvia miltiorrhiza) 50 grams, washed, boiled in water, the juice mixed with 1000 grams of pork long bone, 250 grams of soybeans, cooked until soft, add a small amount of cinnamon and salt, it is ready.

　　9. Fresh crab 500 grams, pounded, served with 250 grams of hot yellow wine, the remaining residue applied to the affected area, it will be good when there is a sound of 'ge ge' after half a day. Used for fracture treatment.

　　1. Early manual reduction should be done to prevent local swelling after reduction.

　　2. After successful reduction, suspend with a neck and wrist band for a week to prevent recurrence and form a habit of dislocation.

　　3. Method of manual reduction: The operator holds the upper part of the affected elbow and wrist with one hand, and presses the radial head with the thumb of the other hand while quickly rotating the forearm backward, flexing the elbow 90° and rotating the forearm forward at the same time. At this time, if you feel a pop like the reduction, it means that the reduction is successful. The child stops crying and can pick up objects and lift them. If there is no pop, the child continues to cry and scream, and the affected hand is still unable to hold objects, it may not have been reduced or reduced too late, and there is swelling locally causing the pop to be not obvious. Observe for a period of time and reduce again if necessary.

　　No anesthesia is used during reduction. First, rotate the forearm backward, extend the elbow slightly, press the thumb on the radial head of the elbow, flex the elbow joint, and rotate the forearm forward and backward if necessary, you can feel the sound of reduction. After reduction, the elbow and forearm can move freely. The elbow and forearm should be suspended with a triangular bandage for a week after reduction. If pain or recurrence occurs during activity, it is advisable to immobilize the elbow at 90 degrees with plaster for 2 weeks, and attention should be paid not to pull the child's arm to prevent recurrence. After the radial head grows at the age of 4 to 6, it is not easy to dislocate.