Presented by MD. MONSUR RAHMAN MPT (Musculoskeletal disorders)

1. Presented
By
MD. MONSUR RAHMAN
MPT (Musculoskeletal disorders)

2.  Pulled Elbow or “Nursemaids Elbow” is common in young children between 1 and
4 years of age . It is due to the annular ligament of the radial head becoming
stretched and entrapped.The child typically allows the arm to hang loosely by
their side in a pronated position.

4.  Breaking a fall with the arm
 Rolling over in an unusual way
 Swinging a young child from the arms while
playing
 Catch a child by the hand to stop a fall.
 Lift a child up by the hands or wrists.
 Pull a child's arm through a jacket sleeve.
 Yank on a child's arm to make him or her walk
faster.

5.  Arm hangs straight down on side of body
 Child is not using the arm
 Pain when moving the arm
 Pain in the elbow, wrist, or shoulder
 a audible snap like sound may have been heard
 the limb is held in extension with the back of the hand facing forward
 if you try to move the elbow then the child cries out in pain
 The child may hold the arm slightly bent (flexed) at the elbow and pressed up
against the belly (abdominal) area.
 The child will move the shoulder, but not the elbow.

6.  Clinically established with a classic history and examination.
 The child will be unable to rotate the arm at the elbow so that
the palm is up and will have trouble bending (flexing) the elbow
all the way.
 The child will not use the affected hand.
 Significant tenderness, swelling, bruising or deformity.

7.  Medical management:
• Over-the-counter pain medicine, such as
acetaminophen tylenol or ibuprofen.
• Rest
• Use of collar cuff sling
• Immobilize the limb by POP.
 Physiotherapy:
• Tapping
• ICE stroking for pain relief.
• Stroking massage for relief of edema.
• After heeling ROM exercise and stretching can be
given.