The nanny's elbow- Syndrome of the pronated elbow - Il gomito della bambinaia- Sindrome del gomito prono (EN-IT)

in #steemstem6 years ago (edited)

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The nanny's elbow- Syndrome of the pronated elbow

The nanny's elbow occurs when the radius, one of the bones of the forearm, is partially displaced proximally of the elbow, usually by a strong traction of the upper member above, in an immature skeleton. It is frequent in children under four years. It is also known as elbow tug, elbow dislocated in children or partial dislocation of the elbow. The term used in orthopedic surgery corresponds to "subluxation of the head of the radius".

Elbow anatomy:

This joint is formed by the head of the radius and the olecranon (proximal epiphysis of the ulna) and the distal epiphysis of the humerus, that is, the humero-ulnar, radial humerous and proximal cubital-radial joint. They are reinforced by a capsuloligamentary medial , lateral, anterior, and posterior complex and the ligaments that support the proximal radioulnar joint itself: Annular ligament and the Denucé ligament.

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Mechanism of injury.

It is presented by energetically lifting the child by the hand or forearm, for example by taking it suddenly when it is about to fall, or by playing swinging the child through the arms. This causes the radius to move away from the annular ligament or the Denucé ligament, which keeps this bone attached to the elbow, losing joint congruency.

Signs and symptoms.

• Pain (the child translates it with crying)

•Characteristic arm position: limitation for movement, the upper limb is pronated (rotated inward and the elbow flexed, resting on the trunk).



The diagnosis should be confirmed with adequate questioning, physical examination and radiographs in anteroposterior and lateral projection of the elbow where the presence of associated fractures should be ruled out and the displacement of the head of the radius of the humeral condyle should be evidenced.

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Then proceed to place the elbow in 90 ° flexion, and take the patient by the hand performing a brief and gentle pronosupination of the elbow (internal and external rotation of the forearm) to ensure that the radial head comes into contact with the articular surface. .

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The best way to check that the reduction has been achieved, is to give the child an object to take it with the hand of the affected elbow, obviously, the child will take it without pain, that way we do not expose it to the radiation, requesting a rx of control . The use of immobilizers or analgesics are not necessary.


• Take care not to throw your child or make him or her go around taking it by the forearm or hand.

• Avoid lifting your child by holding by the arms or hands, if they are going to fall, hold them by their clothes, NEVER by hand.

Bibliographic references:
-Fracturas y luxaciones, Koval y Zuckerman, Ed. Marban.
-Fracturas en el adulto, Rockwood and Green´s.

Il gomito della bambinaia- Sindrome del gomito prono

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“Il gomito della bambinaia” si verifica quando il radio, una delle ossa dell'avambraccio, è parzialmente spostato prossimalmente al gomito, di solito con una forte trazione del membro superiore sopra, in uno scheletro immaturo.
È frequente nei bambini sotto i quattro anni. È anche noto come tiro al gomito, gomito dislocato nei bambini o parziale dislocazione del gomito. Il termine usato in chirurgia ortopedica corrisponde a "sublussazione della testa del radio".

Anatomia del gomito:
Questa articolazione è formata dalla testa del radio e dall'olecrano (epifisi prossimale dell'ulna) e dall'epifisi distale dell'omero, cioè l'articolazione cubitale-radiale umero-ulnare, radiale umorica e prossimale. Sono rinforzati da un complesso capsuloligamentario mediale, laterale, anteriore e posteriore e dai legamenti che sostengono l'articolazione radioulnare prossimale stessa: Legamento Anulare e Legamento di Denucé.

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Meccanismo di lesione.
Si presenta sollevando energicamente il bambino dalla mano o dall'avambraccio, ad esempio prendendolo all'improvviso quando sta per cadere, o giocando oscillando il bambino attraverso le braccia. Questo fa che il radio si allontani dal legamento anulare o dal legamento di Denucé, che mantiene attaccato l'osso al gomito, perdendo la congruenza congiunta.

Segni e sintomi.
• Dolore (il bambino lo traduce con il pianto)
• Posizione caratteristica del braccio: limitazione per il movimento, l'arto superiore è pronato (ruotato verso l'interno e il gomito flesso, appoggiato sul tronco).

La diagnosi deve essere confermata con un adeguato questionario, esame obiettivo e radiografie nella proiezione antero-posteriore e laterale del gomito in cui deve essere esclusa la presenza di fratture associate e deve essere evidenziato lo spostamento della testa del radio del condilo omerale.

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Quindi, si deve procedere a posizionare il gomito in flessione di 90 ° e prendere il paziente per mano eseguendo una breve e delicata pronosupinazione del gomito (rotazione interna ed esterna dell'avambraccio) per garantire che la testa radiale entri in contatto con la superficie articolare.

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Risorsa: personale.

Il miglior modo per verificare che la riduzione sia stata raggiunta è di dare al bambino un oggetto per prenderlo con la mano del gomito colpito; ovviamente, il bambino lo prenderà senza dolore, in questo modo non lo esponiamo alla radiazione, richiedendo ancora un rx di controllo. L'uso di immobilizzatori o analgesici non è necessario.

Prevenzione del gomito della bambinaia.
• Fai attenzione a non gettare il bambino o farlo andare in giro a prenderlo con l'avambraccio o la mano.
• Evitare sollevare il bambino prendendolo per le braccia o le mani, se stanno per cadere, prenderlo per i vestiti, MAI PER I BRACCIA.
Un caro saluto!

Riferimenti bibliografici:
Fracturas y luxaciones, Koval y Zuckerman, Ed. Marban.
Fracturas en el adulto, Rockwood and Green´s.


Hi, @soanna. This article is educational but I think you can make it entertaining as well. No offence but writing an article is quite a difficult endeavour and you need to incorporate some aspect which can be considered as entertaining to attract readers. Be as creative as you can and avoid writing in the WebMD-style article.

  • Most of the images (if not all) are copyrighted which mean you can't use them unless authorised by the original author. Try to find some non-copyrighted images for your article. Some websites like Pixabay or Pexels offer images which are non-copyrighted and safe to use. Please refer here if you're not familiar with what I was talking about.

  • Cite your article's references to make it easy for us (readers) to refer to any websites you used for further reading. Also, it is a good thing for us to give some credit to the original author.

If you have any problem regarding STEM-related articles, you can join steemSTEM Discord Channel and we will be glad to assist you.


Greetings! thanks for the suggestion regarding the images... As a specialist I do not use websites as source, the authors consulted are clear in "References".

I will not link sites or cite anyone because I'm the autor of the text. This article is designed to be understood by all, without complexity. Regards!

I understand the angle @chloroform is coming from.
The link above will help you with pictures that are free from copyright laws just in case you maybe needing more pictures. is also another site

You can join the discord link k he posted earlier for more clarification, the steemstem community is there to explain things much more better.

Hi, thanks for your advice

This information is very important. By obtaining this information, I will never make any further mistakes. I also have two small children and we often make such mistakes. We will take care of this thing, thank you very much.

Hi! thank for comments. I hope this article is useful!

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This is the first time I am reading about this and I must it is really educative.
Weldone @soanna

Many Thanks, Regards!

Ahhh that is painful

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Hi! yes it is, in fact , I had to do the maneuver to my own baby, was very sad!

Very risky to play life

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Yes, unfortunately this is more commom than you imagine.

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