روشي ساده براي جااندازي نيمه دررفتگي ضربه اي سر راديوس در اطفال

A SIMPLE METHOD FOR REDUCTION OF TRA UMATIC SUBL UXA TION OF THE RADIAL HEAD (PULLED ELBOW)

Pulled elbow is one of the most common musculoskeletal injuries in children under four years of age. The lesion is caused by sudden traction on the wrist while the elbow is extended and forearm is pronated. In pronation, the lateral edge of the radial head which opposes the annular ligament is narrower and rounded at itʹs margin. The radial head is oval in shape and in pronation, the narrowest diameter of the radial head is in the anteroposterior plane. After longitudinal traction, a transverse tear in the annular ligament occurs , the anterior portion of the radial head escapes from under the annular ligament and subluxation occurs. Most authors recommend that the reduction can be achieved by supinating the forearm (reversing the mechanism). This outcome study without a control group, reviewed 29 cases of "pulled elbow"which referred to the hospital or a private clinic from Dec 2000 to Dec 2001. In this study, all subluxations were reduced by hyper pronation of the forearm while the elbow was in semiflexion (exaggerating the mechanism). The logic reason is that the anatomical situation of the radial head and annular ligament is in pronation .