What is Nursemaid's Elbow?

Nursemaid's elbow or annular ligament displacement/radial head subluxation is an injury to the ligament that keeps the radius and ulna (bones of the forearm) in position.  Nursemaid's  elbow is a common injury that occurs in children under 3 but can occur at any age.  It occurs when a strong force is applied to the forearm. In hearing this, many may feel that this sort of injury is abuse related. While it is true that this injury can occur, for instance, by a person yanking a young child’s arm, most forearm displacements occur during normal play such as:

-Climbing on monkey bars at the playground
-Swinging by the arms
-Being picked up by the arms
-Pulling arms through a coat
-Grabbing a child by the hand to prevent a fall

Symptoms of Nursemaid's  Elbow

Immediately after the injury the child will begin to cry and hold the injured forearm close to their body. Shortly there after, the child would probably return to normal activity except without use of the affected arm. There is generally no swelling or skin discoloration.

Treatment of Nursemaid's Elbow

First occurrences of this type of injury should be evaluated by a medical professional so a proper diagnosis can be made. Many times doctors instruct caregivers on how to properly “reset” this injury due to the increased likelihood of reoccurrence. If left untreated permanent disability with the affected arm could occur.

Nursemaid's elbow can be treated quickly in a doctor’s office (reduction). If the child is unable to be seen in the office the child should be taken to an emergency department for treatment.  X-rays are generally not required unless swelling or discoloration occurs or if the child is unable to properly use their arm shortly after reduction.

After treatment the child should be back to normal without pain or discoloration and have full use of affected arm. If the child develops pain, swelling, discoloration or any other difficulties medical evaluation is needed.

Prevention of Nursemaid's Elbow Injuries

Preventing nursemaid's elbow injury is key especially if a child has already suffered this type of injury.

-Never pick up a child by their hands or arms
-Always pick up a child under their arms/armpits or around their waist
-Never grab and yank a child by their arms whether it is for discipline or horseplay
-If you’re holding a child by the hand and they begin to wiggle to try and get free, let go and hold them another way.

This information should be used for general education purposes and is not intended to diagnose or treat any health concerns. Any questions or concerns should be brought to the attention of your healthcare provider. 

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