Orthopaedics

Nursemaid's Elbow

What is nursemaid's elbow?

Nursemaid's elbow occurs when the radius (one of the bones in the forearm) slips out of place from where it normally attaches to the elbow joint. It is a common condition in children younger than 4 years of age. It is also called pulled elbow, slipped elbow, or toddler elbow. The medical term for nursemaid's elbow is radial head subluxation.

What causes nursemaid's elbow?

A sudden pulling or traction on the hand or forearm causes nursemaid's elbow. This causes the radius to slip out of the ligament holding it into the elbow. It can occur when an infant rolls himself or herself over, from a fall or from pulling, or swinging a young child by the hand.

What are the symptoms of nursemaid's elbow?

The following are the most common symptoms of nursemaid's elbow. However, each child may experience symptoms differently. Symptoms may include:

• immediate pain in the injured arm
• refusal or inability to move the injured arm
• anxiety

The symptoms of nursemaid's elbow may resemble other conditions or medical problems. Always consult your child's physician for a diagnosis.

How is nursemaid's elbow diagnosed?

The diagnosis of nursemaid's elbow is made with a physical examination by your child's physician.

It is important to call your child's physician immediately, or promptly take your child to the emergency department, if you suspect an injury.

Treatment for nursemaid's elbow:

Specific treatment for nursemaid's elbow will be determined by your child's physician based on the following:

• your child's age, overall health, and medical history
• the extent of the condition
• your child's tolerance for specific medications, procedures, or therapies
• expectations for the course of the condition
• your opinion or preference

Treatment may include:

• acetaminophen (for pain), as directed by your child's physician
• prompt medical treatment while providing reassurance for your child

The injury can usually be reduced (fixed) by your child's physician with ease and often without the need for x-rays (unless other type of injury or fracture is suspected).

Once the elbow has sustained this type of injury, it is more likely to recur. If this happens again, call your child's physician or return to the emergency department for further evaluation and treatment. Most children outgrow the tendency for nursemaid's elbow by the age of 4.

Prevention of nursemaid's elbow:

• Avoid pulling or swinging your child by the arms or hands.
• Avoid lifting your child up by his/her arms or hands.

Consult your child's physician for more information.