Radial head subluxation

　　The articular surface of the radial head and the longitudinal axis of the radius have a certain degree of inclination, which is related to the rotation of the forearm. The change in inclination affects the up and down movement of the annular ligament. In the pronated and supinated positions of the forearm, this variability in inclination undoubtedly makes it easy to dislocate. When the elbow joint is extended and the wrist or forearm is suddenly subjected to a longitudinal pull during rotation, the lower part of the annular ligament will produce a transverse tear, slightly move downwards, and the gap between the humeroradial joint increases. Due to the negative pressure of the joint cavity, the upper part of the joint capsule and the annular ligament only need to slide over a part of the joint surface of the distal end of the radial head to become locked in the radial joint space, thus preventing the reduction of the radial head and causing radial head subluxation.

　　Although the injury of radial head subluxation is not serious, it can still affect the function of the elbow joint. The vast majority of patients need to be复位 to achieve complete recovery. However, the effect of treatment is generally good, without complications. Some children who seek medical attention late may take longer to recover, but complications do not occur.

　　When the elbow is subluxated, the child experiences pain in the elbow, cries and screams, the elbow is semi-flexed, the forearm is moderately pronated, and the child is afraid to supinate and flex the elbow, refuses to lift and move the affected limb, there is tenderness at the radius head, and X-ray examination is negative.

　　Prevention of pediatric radial head subluxation:

　　1. When pulling (lifting) the child's hand, the clothing sleeve 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 should not pull (lift) the hand alone.

　　4. If the above symptoms occur, parents can try to reduce the condition themselves, and if it is not successful, they should go to the hospital for treatment.

　　5. Avoid repeated dislocation to form a habit.

　　6. When dressing, avoid pulling the hand in a supinated position, and pull the clothing sleeve at the same time.

　　This disease has a negative X-ray examination, and it can be diagnosed generally according to clinical manifestations and medical history without the need for auxiliary examination. The key points of diagnosis are as follows:

　　1. This disease is mostly caused by indirect violence, such as: pulling the child's wrist with both hands while walking and falling over; pulling the child's wrist through the sleeve while dressing; rolling on the bed, the upper limb is pressed under the body, forcing the elbow joint to overextend, etc.

　　2. After injury, the affected limb is unwilling to be lifted, and the forearm cannot be supinated.

　　3. The elbow joint is in extension, the forearm is supinated and hanging downward.

　　4. There is no swelling, deformity of the elbow joint, but there is marked tenderness at the radial head.

　　5. No abnormalities on the X-ray film.

　　1. What foods are good for radial head subluxation?

　　Eat light and pay attention to dietary balance.

　　2. What foods should be avoided for radial head subluxation?

　　Avoid spicy and刺激性 food.

　　(The above information is for reference only, please consult a doctor for details)

　　The treatment of this disease mainly relies on manual reduction, without anesthesia during reduction, first rotate the forearm backward, extend the elbow slightly and add traction, press the radial head at the front of the elbow with the thumb, flex the elbow joint, and rotate the forearm forward and backward when necessary, which 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. If there is pain or recurrence during activity, it is advisable to fix the elbow in a flexed position of 90 degrees with plaster for 2 weeks, and attention should be paid not to pull the child's arm to prevent recurrence. After the age of 4-6, the radial head grows larger and is not easy to dislocate.