Nursemaid's elbow is a common injury of early childhood. It is sometimes referred to as "pulled elbow" because it occurs when a child's elbow is pulled and dislocates. The medical term for the injury is "radial head subluxation." Because a young child's bones and muscles are still developing, it typically takes very little force to pull the bones of the elbow out of place, making this injury very common. It occurs most often in children ages 1 to 4, but can happen any time from birth up to age 6 or 7 years old. Although the injury may cause initial pain, a doctor or other healthcare professional can easily reset the elbow, quickly relieving any discomfort and restoring arm movement.
Nursemaid's elbow usually happens in kids 1 to 4 years old. Their ligaments (the elastic-like bands that hold bones together) are a bit loose. So it can be easy for a ligament in the elbow to slip into the joint and get stuck. Nursemaid's elbow can happen with just a small amount of force. For example:
- Pulling a child up by the hands can put stress on the elbows. Never pick up a toddler or infant by the hands or wrists, but lift under the armpits.
- Swinging a toddler by holding the hands or wrists can put stress on the elbow joint and should be avoided.
- Jerking an arm when pulling a toddler along or quickly grabbing his or her hand can make the ligament slip. Always be gentle when taking a child by the hand.
- Breaking a fall by reaching an arm out for protection can overextend the elbow, causing the ligament to slip.
Because moving the injured arm may be painful, the primary symptom of nursemaid's elbow is that the child will hold the arm still at his or her side, and refuse to bend the elbow or use the arm.
At a doctor's office or an emergency room, a doctor will examine the child's arm and ask questions about how the injury happened. Most of the time, no special tests are needed to diagnose nursemaid's elbow. X-rays are done only if a fracture is suspected.
If there's no swelling or signs of another injury, the doctor will do a gentle maneuver called a reduction. This procedure takes only a few seconds. The child will sit on a parent's lap while the doctor gently takes the arm from a straight position and bends it upwards or straightens the arm while turning the palm to the floor.
Kids might have a brief moment of pain during the reduction, but quickly feel much better. Most have full use of the arm within 5 to 10 minutes. Some cases may require more than one reduction to successfully fix the injury.
Nursemaid Elbow Prevention
Avoid any sudden jerking to the hand, wrist, or forearm of any small child to prevent the injury. This is even more important in the children who have previously experienced a nursemaid elbow. Pick up the child by placing your hands on his or her chest and under the axillae.
As your child grows, his or her ligaments will get stronger. So it will become less likely that pulling a child's arms will cause nursemaid's elbow. Until then, you may be able to prevent nursemaid's elbow if you follow these valuable tips.