The annular ligament forms a fibrocartilaginous ring around the radial head, attached to the ulnar radial notch anteriorly and posteriorly. In young children the incompletely formed radial head can slip proximally through the annular ligament producing pulled elbow (nursemaid's elbow, radial head subluxation).
| Origin | Anterior radial notch of the ulna |
|---|---|
| Insertion | Posterior radial notch — completing a ring around the radial head |
| Actions | Retains the radial head in the proximal radioulnar joint during forearm rotation |
|---|
Pulled elbow occurs in children under 5 when the forearm is suddenly pulled while pronated. The child holds the arm pronated and resists supination. Rapid supination with elbow flexion reduces it immediately with a palpable click. Radiographs are normal. Recurrent episodes suggest annular ligament laxity.
Radial head subluxation through the annular ligament in young children from a pulling force, reduced by rapid forearm supination with elbow flexion.
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