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trauma-list digest, Vol 1 #1419 - 17 msgs

Michael Tanner trauma-list@trauma.org
Wed, 5 Jun 2002 04:30:37 +0200

Re: deging@medcor.com

Hi there dave,
what you=B4ve just described is called "pronation doloureuse Chassaignac", "=
M. Chassaignac" or "nursemaid=B4s elbow", a condition caused by sudden, inte=
nse pulling on the child=B4s extended arm. This, because of=20
insufficient muscular stability of the proximal radio-ulnar joint, leads t=
o subluxation of the radial head under the anular ligament. Clinically, th=
e child shows a blocked pronation of the arm, which is left hanging. As th=
e history and clinical impression are classic, this actually doesn=B4t neces=
sarily warrant an x-ray (I wouldn=B4t, at least). Treat it best by fully fle=
xing the child=B4s elbow and then, while pressing on the head of the radius =
supinating and extending at the same time. You=B4ll hear and feel a "plop" (=
don=B4t worry, you=B4ve only reduced the subluxation) and within minutes, the =
child=B4ll be using it=B4s arm as if almost nothing had happened. VERY satisfy=
ing for all (patient, parents and yourself). No splinting is necessary!!

Have fun out there!
Michael C. Tanner, M.D.

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