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A pulled elbow typically results from a sudden pull on an extended arm. [2] This may occur when lifting or swinging a child by the arms. [2] The underlying mechanism involves slippage of the annular ligament off of the head of the radius followed by the ligament getting stuck between the radius and humerus. [1] Diagnosis is often based on ...
The annular ligament (orbicular ligament) is a strong band of fibers that encircles the head of the radius, and retains it in contact with the radial notch of the ulna. [ 1 ] Per Terminologia Anatomica 1998 , the spelling is "anular", [ 2 ] but the spelling "annular" is frequently encountered.
Ulnar collateral ligament reconstruction, colloquially known as Tommy John surgery, is a surgical graft procedure where the ulnar collateral ligament in the medial elbow is replaced with either a tendon from elsewhere in the patient's body, or with one from a deceased donor.
The distal attachment of the annular ligament covering the radial head is weaker in children than in adults, allowing it to be more easily torn. The older child will usually point to the dorsal aspect of the proximal forearm when asked where it hurts. This may mislead one to suspect a buckle fracture of the proximal radius. [2]
Olecranon fractures are rare in children, constituting only 5 to 7% of all elbow fractures. This is because in early life, olecranon is thick, short and much stronger than the lower extremity of the humerus. [5] However, olecranon fractures are a common injury in adults. This is partly due to its exposed position on the point of the elbow.
The head of the radius has a cylindrical form, and on its upper surface is a shallow cup or fovea for articulation with the capitulum of the humerus.The circumference of the head is smooth; it is broad medially where it articulates with the radial notch of the ulna, narrow in the rest of its extent, which is embraced by the annular ligament.
There is calcification of annular ligament, which can be seen as early as 2 weeks after injury. [29] Elbow dislocations constitute 10% to 25% of all injuries to the elbow. The elbow is one of the most commonly dislocated joints in the body, with an average annual incidence of acute dislocation of 6 per 100,000 persons. [30]
Ulnar collateral ligament injuries can occur during certain activities such as overhead baseball pitching. Acute or chronic disruption of the ulnar collateral ligament result in medial elbow pain, valgus instability, and impaired throwing performance. There are both non-surgical and surgical treatment options.