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16 Cards in this Set
- Front
- Back
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Annular ligament displacement (ALD) is a common injury seen in what age range?
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1-3 years old
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ALD usually occurs as a result of what?
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A sudden longitudinal force of accelerated distraction on the affected arm, with the forearm in proximal pronation, and the elbow extended or hyperextended
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The annular ligament normally encircles and stabilizes what?
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the radial head and allowing it to rotate on its long axis
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With distal traction on the radius, the annular ligament does what?
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becomes displaced over the radial head and into the radiohumoral joint space
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If 8-12 hours pass before the elbow is rest, what may happen?
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thw swelling may impede spontaneous repositioning of the ligament back onto the head of the radius
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ALD is more common in what sex?
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females
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With ALD, there is usually a history of what?
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axial traction of the affected limb
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How does a child typically hold the affected arm in ALD?
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-in pronation, adduction, internal rotation, and partial flexion at the elbow, often protecting and splinting with the unaffected hand
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In ALD, the pt is typically comfortable at rest, but will begin to cry with what?
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any movement of the affected elbow, especially with supination
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In ALD there is no what?
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rubor, tumor, or calor
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In ALD, neurovascular exam of affected limb is what?
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normal
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Dx of ADL is made how?
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H and P
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What is the Dx/Dx in ALD?
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-fracture
-soft tissue trauma -infection -arthritis -tumor -neurovascular disorder |
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Explain the tx of ALD?
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-while supporting the pts elbow with the fingers, apply pressure with your thumb over the radial head
-fully supinate, externally rotate, and extend the arm at the elbow -Then, flex the elbow, bringing the patient's hand to their shoulder |
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In the tx of ALD, there is often a click that will be palpated, which indicates what?
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acute reduction of the annulus into nomral position over the radial head
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What is the management of ALD if you fail to reduce it?
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-get baseline x-ray
-examine the pt for possible inurys to the clavicle, humer, or other structures of the shoulder and upper extremity -place arm in a sling at 90 degrees of flexion -provide pediatric or orthopedic follow-up w/in 24-48 hrs -spontaneous self-reduction usually occurs during this period,as inflammatory changes subside |
