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If the forearm of a young child is pulled, it is possible for this traction to pull the radius into the annular ligament with enough force to cause it to be jammed therein. This causes significant pain, partial limitation of flexion/extension of the elbow and total loss of pronation/supination in the affected arm.
The annular ligament (orbicular ligament) is a strong band of fibers that encircles the head of the radius, and retains it in contact with the radial notch of the ulna. [ 1 ] Per Terminologia Anatomica 1998 , the spelling is "anular", [ 2 ] but the spelling "annular" is frequently encountered.
In radial head subluxation, there is little complaint of pain, and the person generally reports pain in the proximal forearm. The mechanism is slippage of the head of the radius under the annular ligament. The distal attachment of the annular ligament covering the radial head is weaker in children than in adults, allowing it to be more easily torn.
An ulna fracture is a break in the ulna bone, one of the two bones in the forearm. [2] It is often associated with a fracture of the other forearm bone, the radius. [1] [3]An ulna fracture can be a single break as in a so called nightstick fracture, which can be caused by someone being hit on the inside of the forearm often by a stick, notably when they are holding their arm up to protect ...
It occurs between the circumference of the head of the radius and the ring formed by the radial notch of the ulna and the annular ligament. [2] The interosseous membrane of the forearm and the annular ligament stabilise the joint. [2] A number of nerves run close to the proximal radioulnar joint, including: median nerve; musculocutaneous nerve ...
the annular ligament (AL), from the posterior to the anterior margins of radial notch on the ulna, encircles the head of radius and holds it against the radial notch of ulna. [5] the accessory lateral collateral ligament (ALCL), from the inferior margin of the annular ligament to the supinator crest.
The circumference of the head is smooth; it is broad medially where it articulates with the radial notch of the ulna, narrow in the rest of its extent, which is embraced by the annular ligament. The deepest point in the fovea is not axi-symmetric with the long axis of the radius, creating a cam effect during pronation and supination.
It can cause pain, stiffness, loss of sensation, and weakness radiating from the inside of the elbow to the fingers. Rest is the primary intervention for this injury. Ice, pain medication, steroid injections, strengthening exercises, and avoiding any aggravating activities can also help. Surgery is a last resort, and rarely used.