Elbow: radial head subluxation: practice question

A Anatomy question in the style of the NEET PG paper. Answer it first, then read why the right option is right and why each of the others is wrong.

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Anatomy · Elbow: radial head subluxation

Sample item

A 2-year-old girl cries after her father pulls her up by the hand to prevent a fall. She now holds her arm slightly flexed and pronated and refuses to move it, with no swelling. What is the mechanism of injury?

Original practice item, not a recalled exam question. Nothing here is recorded.

The answer and the reasoning

B. The radial head slips distally out of the annular ligament

Nursemaid elbow is subluxation of the radial head through the annular ligament, caused by sudden longitudinal traction on the extended pronated forearm. In young children the head of the radius is small and the ligament is loose, and reduction by supination and flexion or hyperpronation is usually curative. The condition is rare after about 5 years of age.

Option by option

  • A. The ulnar collateral ligament ruptures

    The ulnar collateral ligament does not rupture with longitudinal traction in a toddler.

  • B. The radial head slips distally out of the annular ligament (correct)

    Correct. The head of the radius is pulled out from under the annular ligament.

  • C. The medial epicondyle is avulsed from the humerus

    Medial epicondylar avulsion causes swelling and pain and follows a fall or valgus stress.

  • D. The olecranon fractures through the growth plate

    An olecranon fracture follows a direct blow and causes swelling and inability to extend the elbow.

Source note: Original NextPrep sample item — pending expert review. This item is original practice material awaiting independent expert review, so confirm important facts in a standard textbook.

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Questions about this Anatomy question

What is the answer to this Anatomy question?

The best answer is B, The radial head slips distally out of the annular ligament. Nursemaid elbow is subluxation of the radial head through the annular ligament, caused by sudden longitudinal traction on the extended pronated forearm.

Why is "The ulnar collateral ligament ruptures" not the answer?

The ulnar collateral ligament does not rupture with longitudinal traction in a toddler.

Why is "The medial epicondyle is avulsed from the humerus" not the answer?

Medial epicondylar avulsion causes swelling and pain and follows a fall or valgus stress.

Why is "The olecranon fractures through the growth plate" not the answer?

An olecranon fracture follows a direct blow and causes swelling and inability to extend the elbow.

What concept does this question test?

It tests Elbow: radial head subluxation in Anatomy. In young children the head of the radius is small and the ligament is loose, and reduction by supination and flexion or hyperpronation is usually curative. The condition is rare after about 5 years of age.

How hard is this question?

We tag it as an application question: it asks you to use a fact on a patient or a finding. The tag is our own editorial judgement, not an official difficulty rating, so read the reason for every option, not only the answer.

How should I study Elbow: radial head subluxation?

Learn every nerve by its route, its muscles and what a lesion looks like at the bedside. That one habit answers a large share of questions. Then use the flashcards and the other Anatomy questions on this site to test what stuck.

Is this a real NEET PG question?

No. It is an original practice item (editorial status: sample, version 1). NextPrep does not publish recalled or leaked questions, and independent faculty review of this item has not been completed yet, so confirm important facts in a standard textbook.