Question:
A 4-year-old child, while playing, was suddenly swung around by the elbow from the maid's hand and is now crying continuously, not allowing anyone to touch the elbow. The child keeps the elbow extended. What is the most likely diagnosis?
A 4-year-old child, while playing, was suddenly swung around by the elbow from the maid's hand and is now crying continuously, not allowing anyone to touch the elbow. The child keeps the elbow extended. What is the most likely diagnosis?
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A sudden pull on a toddler's extended arm with no swelling suggests what?
Updated On: Jun 23, 2026
- Radial head fracture
- Pulled elbow
- Supracondylar fracture
- Elbow dislocation
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The Correct Option is B
Solution and Explanation
Answer: Pulled elbow.
Step 1: The history is a sudden axial pull or swing on an extended, pronated arm in a young child. This is the classic mechanism of pulled elbow (nursemaid's elbow), a subluxation of the radial head out of the annular ligament.
Step 2: The child holds the affected arm still, often slightly flexed and pronated or held by the side, refuses to use it, and resents being touched, but there is no significant swelling or deformity.
Step 3: A supracondylar fracture or elbow dislocation would usually follow a fall on an outstretched hand and show marked swelling or deformity. A radial head fracture is uncommon at this age and again usually follows a fall, not a simple pull.
Step 4: The pull mechanism with no deformity is typical of pulled elbow. A fracture should still be excluded, but the clinical picture is diagnostic. Ref: Apley and Solomon's System of Orthopaedics.
Step 1: The history is a sudden axial pull or swing on an extended, pronated arm in a young child. This is the classic mechanism of pulled elbow (nursemaid's elbow), a subluxation of the radial head out of the annular ligament.
Step 2: The child holds the affected arm still, often slightly flexed and pronated or held by the side, refuses to use it, and resents being touched, but there is no significant swelling or deformity.
Step 3: A supracondylar fracture or elbow dislocation would usually follow a fall on an outstretched hand and show marked swelling or deformity. A radial head fracture is uncommon at this age and again usually follows a fall, not a simple pull.
Step 4: The pull mechanism with no deformity is typical of pulled elbow. A fracture should still be excluded, but the clinical picture is diagnostic. Ref: Apley and Solomon's System of Orthopaedics.
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