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Nursemaids Elbow

What is a Nursemaid’s Elbow?

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.”

This may be also referred to it as a radial head subluxation. The injury is not often seen in kids older than 5 or 6. That’s because as children grow, their bones harden and the ligaments get tighter and thicker. This helps keep the elbow firmly in place.

Mechanism of Injury

  • Catch a child by the hand to stop a fall
  • Lift a child up by the hands or wrists
  • Pull a child’s arm through a jacket sleeve
  • Swing a child by the arms or hands
  • Yank on a child’s arm to make him or her walk faster

Sometimes nursemaid’s elbow may happen if:

  • An infant rolls over onto the arm
  • A child uses the hands to brace himself or herself during a fall

Signs and Symptoms

  • Pain or inability when attempting to use the arm
  • Limited ROM
  • No swelling or bruising is noted

Imaging

  • XR will determine if the radial head is dislocated or if an underlying fracture is present.

Treatment

  • Reduction is advised to relocated the radial head
  • Supination and flexion of the elbow as demonstrated in the photo
  • Child should begin to use the arm normally within 10-15 minutes of reduction
All links and resources are provided for general educational purposes only. For specific medical recommendations regarding your child, see a board-certified pediatric orthopedic surgeon.