What is not true about pulled elbow?

Pulled elbow Occur in children between 2-5 years of age. The head of radius is pulled paly out of annular ligament when a child is lifted by the wrist. The child stas crying and is unable to move the affected limb. The forearm.lies in attitude of pronation. There may be mild swelling at the elbow. Treatment: head is reduced by fully supinating the forearm and applying direct pressure overhead of radius. A sudden click is heard or felt as head goes back to place. Ref: Essential Ohopaedics, Maheswari & Mhaskar, Edition 9 Page no: 105