Nursemaid's elbow Health Article

Definition

Nursemaid's elbow is a partial dislocation of the elbow, which occurs when the lower part of the arm (forearm) slips out of its normal position at the elbow joint.

The injury is also called radial head dislocation.

Alternative Names

Radial head dislocation; Pulled elbow; Dislocated elbow - children; Elbow - nursemaid's; Elbow - pulled; Elbow subluxation; Dislocation - elbow - partial; Dislocation - radial head

Causes, incidence, and risk factors

Nursemaid's elbow is a common condition in young children and generally affects children under age 5. The injury occurs when a child is pulled up too hard by the hand or wrist. It is often seen after someone lifts a child up by one arm up. (For example, when trying to lift the child over a curb or high step.) Swinging a young child from the arms while playing can also cause this injury.

When the injury occurs, the child usually begins crying immediately and refuses to use the arm. The child may hold the arm so that is slightly bent (flexed) at the elbow and pressed up against the belly (abdominal) area. The child will move the shoulder, but not the elbow. Some children stop crying as the immediate pain goes away, but continue to refuse to move the elbow.

Once the elbow dislocates, it is likely to do so again, especially in the 3 or 4 weeks following the injury.

Nursemaid's elbow does not usually occur after age 5. By this time, a child's joints and surround structures are stronger, and the child is less likely to be in a situation where this injury might occur. However, in some cases, the injury can occur in older children or adults, usually from a fracture of the forearm.

Symptoms

• Immediate crying
• Complaints of elbow pain
• Refusing to use the arm that is injured
• Holding elbow slightly bent at the elbow
• Holding the lower part of the arm against the belly area (abdomen)
• Moving arm at shoulder but not elbow

If you think your child has nursemaid's elbow:

• DO NOT move the child without first splinting the arm.
• DO NOT try to straighten the arm or change its position.

Apply an ice pack to the elbow. Splint the injured arm in the position in which you found it. Keep the area both above and below the injured elbow from moving, including the shoulder and the wrist, if possible.

Take the child to the doctor's office or emergency room.