Elbow Pronation: Causes And Treatment
Elbow pronation is a pathological condition with several names. In fact, it is also known as painful pronation, elbow lock or nanny’s elbow. The exact name is actually radius head subluxation.
Perhaps the most interesting denomination is that of nanny’s elbow. This name is due to the clinical picture presented when the problem was first described, since it was a lesion often caused by, which occurred when they took children by the hand, in a completely unintentional way.
In general it is a trauma that adults cause to children by sharply stretching one of the upper limbs of the children. The adult in question may be the father, mother, grandparents or any other person, but it has become famous with reference to the nanny.
What does elbow pronation consist of?
In medical terms, elbow pronation is motion paralysis. The baby’s elbow is unable to carry out the pronosupination movement, that is, it cannot rotate around its own axis. The block, of course, causes pain.
The age at which it occurs varies between one and five years. It very rarely occurs in children over seven years of age. Curiously, it tends to affect the left elbow more than the right one and girls suffer from it more than boys.
Cases outside the usual age range have been recorded, but they are exceptions. The bilateral version is also an exception, since the manifestation mechanism rightly responds to constant solicitation from one of the two sides.
How does elbow pronation occur?
The cause of this injury is sudden traction. An excessive and fast stress of one of the two upper limbs causes the head of the radius to move away from its anatomical position, without the possibility of repositioning; this causes a block of movement.
First of all, it must be understood that the elbow joint consists of three bones: the humerus, the radius and the ulna. The humerus is the arm bone that develops between the shoulder and the elbow. The radius and ulna are bones of the forearm, between the elbow and the wrist.
In order for the tip of the radius to remain in place, articulating with the humerus above and with the ulna in the direction of the ribs, there is an annular ligament. The annular ligament surrounds the head of the radius and gives it movement, preventing it from coming out of the joint.
Up to the age of seven, the annular ligament is immature and weak. It stretches easily and does not have the resistant elasticity it will acquire with growth and development. For this reason, elbow pronation is more common in children, especially before the age of seven.
With this anatomical structure in mind, we can better imagine the mechanism of the injury. Generally, an adult takes a child by the hand or wrist, to help him climb stairs or to prevent him from falling, by jerking the child’s arm sharply; in this way, the radius head overcomes the resistance of the annular ligament by moving.
The elbow remains locked and the child can no longer rotate the forearm to switch between palm-up and palm-down position. This is prevented by the radius head being out of position.
No genetic inheritance has been found that predisposes more to this type of injury. Some children have more ligament laxity, so it makes sense to run a higher risk of subluxation. No child is immune to it.
Elbow pronation symptoms
The quintessential symptom of elbow pronation is pain. Very young children manifest it with intense crying, and older children can signal it by pointing to the affected area.
The pain appears immediately after the abrupt traction. The child keeps the elbow extended and resists trying to move it while moaning. In addition to the stretched elbow, the child holds the upper limb attached to the body.
Although the affected joint is only that of the elbow, observing the position assumed, it can be confused with a wrist and shoulder injury. The noise caused by the subluxation can also be confusing by suggesting that it is coming from another joint.
The injured adult may feel an unusual stretch in the child’s limb when pulling, but this is not always the case. The attention will be drawn to the crying and the extended position of the forearm.
Treatment
The treatment is simple if performed by specialized medical personnel. It requires no surgery and a routine visit can fix the problem in a short time.
IS It is essential that the consultation take place within twelve o’clock of the injury. The health professional will perform the indicated maneuvers to this end and return the radius head to its original position. The movement of the elbow is recovered immediately.
Elbow pronation may recur, but it is less likely as the baby grows and develops. In case of relapse, the treatment is the same: the maneuver performed by healthcare professionals for the repositioning of the radius.
Consequently, there is no need for parents to despair if the child exhibits symptoms of elbow pronation. It is essential to remain calm and seek medical attention to resolve the problem. Maneuvers performed in time and correctly leave no marks and give immediate pain relief.
