What is Nursemaid’s Elbow?

Nursemaid’s elbow, medically known as radial head subluxation, is a common elbow injury in young children, particularly those under the age of five. It occurs when the radius (one of the forearm bones) partially slips out of its normal position at the elbow joint. This injury can cause discomfort and temporary loss of arm movement but is typically not serious and can be easily treated by a medical professional.

Young children have more flexible ligaments, making them more susceptible to joint injuries like child elbow injury. Understanding how nursemaid’s elbow occurs and recognizing its symptoms can help ensure prompt treatment and prevent future occurrences.

Causes of Nursemaid’s Elbow

Nursemaid’s elbow usually happens due to a sudden pulling motion on a child’s outstretched arm. Common causes include:

• Lifting a child by their hands or wrists instead of supporting them under the arms.
• Swinging a child by their arms, which puts stress on the elbow joint.
• A sudden fall where the arm is jerked or twisted while trying to break the fall.
• Rolling over in bed, which in some cases can cause the elbow to slip out of place in younger children.

As children grow and their ligaments strengthen, the risk of dislocated elbow in children decreases significantly.

Nursemaid’s Elbow Symptoms

Recognizing nursemaid’s elbow symptoms can help parents and caregivers seek appropriate medical care. A child with nursemaid’s elbow may exhibit:

• Refusal to use the affected arm – The child may hold their arm close to their body and avoid movement due to discomfort.
• Pain near the elbow – Though often mild, some children may cry or complain of soreness.
• No visible swelling or bruising – Unlike fractures or other joint injuries, nursemaid’s elbow does not usually cause significant swelling or discoloration.
• Limited range of motion – The child may be unable to bend or rotate their forearm.

If a child shows these symptoms, it is important to seek medical attention. According to the Mayo Clinic, a physical examination is often sufficient for diagnosis, and imaging tests like X-rays are only needed if a fracture is suspected.

Treatment for Nursemaid’s Elbow

The primary treatment for nursemaid’s elbow involves a healthcare provider performing a quick and painless maneuver to guide the dislocated bone back into place. This procedure, known as a reduction, typically restores full movement almost immediately.

After treatment:

• The child may experience mild soreness for a few hours.
• They should regain normal use of their arm shortly after the procedure.
• In some cases, a sling may be recommended to prevent re-injury.

If a child experiences repeated episodes of nursemaid’s elbow, a doctor may provide parents with guidance on how to prevent future occurrences. More information on reducing joint dislocations in children can be found at the American Academy of Orthopaedic Surgeons.

When to Seek Medical Attention

Parents should consult a doctor if:

• The child refuses to move their arm for an extended period.
• The injury was caused by a significant fall or trauma.
• There is noticeable swelling, bruising, or deformity.
• The elbow does not regain full function after treatment.

Preventing Nursemaid’s Elbow

While not all cases can be avoided, parents and caregivers can take steps to reduce the risk:

• Avoid pulling or swinging a child by their arms or hands. Instead, lift them from under the arms.
• Teach older siblings and caregivers proper handling techniques to prevent accidental injuries.
• Encourage careful play and avoid rough pulling games.

The Role of Physical Therapy in Recovery and Prevention

Most cases of nursemaid’s elbow resolve quickly after a reduction procedure. However, some children may experience lingering discomfort or repeated dislocations. In such cases, physical therapy can help strengthen the surrounding muscles and improve joint stability.

A structured rehabilitation program, such as those available at Lattimore Physical Therapy, can provide guidance on safe movement techniques and exercises to help prevent future injuries.

By understanding the causes, symptoms, and treatments for nursemaid’s elbow, parents and caregivers can respond appropriately if an injury occurs and take steps to reduce the risk of recurrence. Ensuring proper handling and seeking timely medical care can help young children maintain healthy joint function and mobility.