What are the symptoms of nursemaid’s elbow?

Nursemaid’s elbow, also known as radial head subluxation or pulled elbow, is a common injury in young children, typically between the ages of 1 and 4 years. It occurs when a child’s elbow is pulled or yanked, causing the radius (one of the bones in the forearm) to partially dislocate from the ligaments that hold it in place at the elbow joint.

The main symptom of nursemaid’s elbow is sudden onset of pain in the child’s arm, particularly around the elbow. The child may also hold their arm close to their body and refuse to move it. Other symptoms may include:

1. Tenderness: The area around the elbow may be tender to the touch.
2. Swelling: There may be some swelling around the elbow joint.
3. Limited range of motion: The child may have difficulty or refuse to straighten or bend their arm at the elbow.
4. Crying or fussiness: Young children may cry or be irritable due to the pain and discomfort.

It’s important to note that nursemaid’s elbow does not usually cause visible deformity or swelling, and the child’s arm may appear normal despite the injury. If you suspect that your child has nursemaid’s elbow, it’s best to seek medical attention from a healthcare professional, such as a pediatrician or an emergency room doctor, who can perform a gentle manipulation to relocate the elbow joint and relieve the pain.

What are the causes of nursemaid’s elbow?

Nursemaid’s elbow is caused by a sudden pulling or yanking force on a child’s forearm, which can partially dislocate the radius bone from the ligaments that hold it in place at the elbow joint. This injury typically occurs when a child’s arm is pulled or jerked while the elbow is extended, such as when an adult grabs a child’s hand or wrist and pulls them along, or when a child’s arm is pulled through a sleeve forcefully.

Nursemaid’s elbow is more common in young children, particularly between the ages of 1 and 4 years, because their ligaments and joint structures are still developing and are more prone to injury from sudden or excessive forces. Activities that involve swinging a child by the arms or lifting a child by one arm can also increase the risk of nursemaid’s elbow.

What is the treatment for nursemaid’s elbow?

The treatment for nursemaid’s elbow typically involves a simple and gentle procedure called a reduction, which is performed by a healthcare professional. Here’s an overview of the treatment process:

1. Medical evaluation: A healthcare provider will assess the child’s arm and elbow to determine if nursemaid’s elbow is the likely diagnosis. This may involve asking about how the injury occurred and examining the arm for tenderness, swelling, and limited range of motion.
2. Reduction procedure: If nursemaid’s elbow is suspected, the healthcare provider will perform a reduction to relocate the partially dislocated radius bone back into place. This is typically done using a technique called supination and flexion, which involves gently rotating the child’s forearm so that the palm faces upward (supination) and then bending the elbow (flexion).
3. Pain relief: The reduction procedure is usually quick and relatively painless. After the procedure, the child may experience some relief from the pain and discomfort.
4. Monitoring: After the reduction, the healthcare provider may observe the child for a short period to ensure that the elbow remains stable and that there are no complications.
5. Home care: Once the elbow is back in place, the child can usually resume normal activities. However, it’s important to avoid pulling or jerking the child’s arm to prevent recurrence of nursemaid’s elbow.

In some cases, the reduction procedure may need to be repeated if the elbow becomes partially dislocated again. Recurrence of nursemaid’s elbow is more common in children who have experienced it before. If nursemaid’s elbow recurs frequently or if there are other concerns, further evaluation by a healthcare provider may be necessary.