Nursemaid’s elbow

What is a nursemaids elbow?

• Nursemaid’s elbow is a common elbow injury usually occurring in children age 5 or younger.
• When the injury occurs, the top of the radius bone of the forearm has slid out of proper position at the elbow joint.

What causes a nursemaids elbow?

• Typically, it occurs when the child’s arm is pulled in an upward direction when being helped up or during play.
• How is the diagnosis of nursemaid’s elbow made in a child?
• A doctor can usually make this diagnosis based on the expected history and physical examination.
• A child with this injury usually holds their arm close to their body and flexed (their palm facing their body or slightly down to the ground).
• Typically, no swelling or redness is present around the injury.
• The child refuses to move the hand and arm - any movement that turns the palm up is painful.
• Xrays do not reveal a fracture and are unnecessary in a straightforward case.
• X-rays will usually be done if the history of injury is unknown or not typical or the examination is difficult.

What is the treatment of a nursemaids elbow?

• Your physician will perform a maneuver to place the radius bone back into position.
  your physician can usually feel it pop back into position
• If successful, the child usually uses the arm normally again within 10 – 30 minutes.
• Usually no splint or cast is needed unless the child continues not to use the arm normally and the maneuver has felt to be unsuccessful.
• This is more likely if the injury is not treated quickly or the injury has occurred many times before.

How can I prevent a nursemaids elbow?

• Anyone who is with the child should try not to lift them by the end of one arm--sudden pulls of the hand or wrist can easily cause this injury.