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Is My Child at Risk for Nursemaid’s Elbow or Pulled Elbow?

As parents, we’re all too familiar with childhood mishaps and minor injuries. From scraped knees to bumped heads, we’ve seen it all. And among these, there’s one surprisingly common injury you may not be familiar with: nursemaid’s elbow.

Despite its name, it’s not just nurses who need to be aware of this condition. It’s something that can happen to children, typically younger than 5

Allison Lane, MD, a sports medicine specialist with Banner – University Medicine, helps us understand nursemaid’s elbow, what causes it and, most importantly, how to treat and prevent it.

What is nursemaid’s elbow?

Medically known as radial head subluxation, nursemaid’s elbow is a condition where the radius bone in the forearm slips out or is pulled out of its normal position at the elbow joint. As a result, the elbow becomes partially dislocated.

“The ligament, or strong tissue that connects the bones in this area, is not fully formed in young children, allowing the bone to slide out of place more easily,” Dr. Lane said. 

Luckily, as children grow the ligament strengthens, making this injury less likely to happen.

Causes of nursemaid’s elbow

“Nursemaid’s elbow most commonly occurs when a child is pulled by the arm,” Dr. Lane said. “Because the ligament is weaker in young children, it takes very little force to pull the joints of the elbow.”

Nursemaid’s elbow can occur when:

  • You are lifting, spinning or swinging your child around by their arms or hands.
  • You are pulling or grabbing their hand to stop them from falling or running away.
  • They stop a fall with outstretched arms.

Symptoms of nursemaid’s elbow

A nursemaid’s elbow can sometimes be tricky to spot. The elbow may not look swollen or bruised like you see with broken bones. However, your child might complain of pain or avoid using their arm.

“They might avoid using the arm or hold it straight by their side,” Dr. Lane said.

If your child is complaining of pain and refuses to use their arm, see your child’s health care provider or go to the nearest urgent care or emergency room to have their arm looked at.

“The diagnosis can usually be made by asking how the injury happened and examining the arm,” Dr. Lane said. “If the story isn’t clear or there is any concern for a broken bone, an X-ray may be ordered.”

Treatment of nursemaid’s elbow

The treatment for nursemaid’s elbow is a procedure called reduction. 

“During a reduction, a health care provider gently moves the bone back into the correct position,” Dr. Lane said. “This is often a quick procedure so there is only momentary pain, if any at all.”

After reduction, your child may experience immediate relief from pain. They should start moving their arm normally in less than 30 minutes, sometimes even right away. There is usually no need for slings or splints.

Can my child get nursemaid’s elbow again?

“While this injury does not cause permanent problems when fixed quickly, it is more likely to happen again once there is a first injury,” Dr. Lane said. 

Here are some tips to help prevent nursemaid’s elbow from happening again…or in the first place:

  • Be gentle: Avoid pulling or tugging on your child’s arm, especially when their forearm is twisted. 
  • Educate others: Make sure that anyone who cares for your child, such as family members, babysitters or child care providers, understands the risks of nursemaid’s elbow and how to handle children safely.
  • Supervise play: Keep an eye on your child during playtime to prevent falls or accidents that could lead to injury.
  • Teach safe practices: Encourage your child to use proper techniques when playing and lifting objects to reduce the risk of injury.

Takeaway

Nursemaid’s elbow is a common childhood injury that can cause temporary pain but is usually easy to treat. Luckily, there are steps you can take to prevent it from happening. 

If nursemaid’s elbow does happen, prompt treatment is important. See your child’s health care provider, a Banner health expert or visit your nearest urgent care or emergency department. Once treated, your child should be able to return to normal activities quickly. With knowledge and care, you can help keep your child healthy and happy. 

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Orthopedics Children's Health