Nursemaid elbow is a common elbow injury, especially among young children and toddlers. It occurs when a child’s elbow is pulled and one of the bones partially dislocates, giving it another name, “pulled elbow.” Your doctor may refer to it as a radial head subluxation.
This injury was named during a time when nursemaids (or nannies) commonly cared for children and had the reputation of causing this injury by pulling on a child’s outstretched arm.
The bones and ligaments of a young child are often soft and still developing. This makes it easy to sustain injuries of this type. Typically, nursemaid elbow is found in children between the ages of 1 to 4, but can be found in slightly older children as well.
Because ligaments will tighten as a child gets older, most won’t get nursemaid elbow after they turn 5 years old.
The most common symptom of nursemaid elbow is pain. Usually a child will hold the injured arm to their side without moving it in order to prevent further pain.
You might see the child holding their arm with a slight bend or straight at their side. Nursemaid elbow can be difficult to diagnose because it doesn’t cause swelling or disfigurement.
Nursemaid elbow can occur when force is exerted on the child’s arm when it’s outstretched, pulling at the elbow joint. This can happen a number of ways, most commonly when pulling a child up by the hands. It can also happen when swinging a child by the hands, or jerking a child’s arm. Less commonly, a child might roll over their arm in a crib or bed and cause this injury.
Nursemaid elbow is rarely the result of a fall. A fall is more likely to cause a fracture or break.
If your child is holding their arm in an awkward way or is complaining of pain, make an appointment with their pediatrician.
Their doctor will typically make a physical assessment of the injured arm, diagnosing nursemaid elbow based on the way the elbow was injured and how the child is holding their arm. An X-ray isn’t required, but may be done in order to rule out fractures and broken bones.
Your child’s doctor will treat nursemaid elbow through a process called reduction. It involves gently moving the bone and ligament back into place. The doctor will fold the child’s arm upward from a straight position, turning the palm as the arm bends at the elbow. They’ll support your child’s elbow with the other hand. You may hear a faint pop or click.
Though the process will only take a few seconds, your child may experience temporary pain during the reduction. Afterward, they’ll usually feel much better than before. Most of the time, children are able to use their arm again within 5 to 10 minutes. However, it’s possible your child might require more than one reduction to heal.
Can nursemaid elbow be fixed at home? Or heal without treatment?
If your child has had nursemaid elbow more than once, you may ask your doctor about learning the technique for reducing the partial dislocation. You shouldn’t consider trying to treat this yourself if you’re not sure the injury was from pulling on your child’s arm, rather than from a fall. You should also not try home treatment if you’re not sure where in the arm your child’s pain is located. Fractures of the clavicle (collarbone) and wrist are also common in young children. These injuries can be made worse by bending and moving the arm. Children will occasionally reduce the partial dislocation themselves while playing or otherwise moving their arm, but usually they consciously hold their arm still to avoid pain.Karen Gill, MDAnswers represent the opinions of our medical experts. All content is strictly informational and should not be considered medical advice.
While nursemaid elbow injuries are often initially painful, they are treatable. Your doctor will be able to reset the elbow, which will both relieve discomfort and restore movement.
Those who experience nursemaid elbow are more likely to experience it again. It’s important to take preventative measures to avoid jerking or pulling on the child’s arm.