Nursemaid’s elbow in children
Many children squeal
with delight when you swing their arms. But did you know that this fun activity
can lead to one of the most common injuries in young children?
This is called "nursemaid's
elbow" and it can be very painful for your little one.
Nursemaid's elbow
means that the elbow has slipped out of its normal place in the joint.
The ulna (radius) is
connected to the elbow joint (humerus) by elastic bands called ligaments. These
ligaments strengthen and tighten as the child grows. In young children and
infants, the ligaments are still loose. This allows the elbow to slide easily.
Your doctor or nursemaid
may use other terms for nursemaid's elbow, such as:
- Pulled elbow
- Radial head subluxation
Who gets the nursemaid's elbow?
Nursemaid's elbow is
a common injury in toddlers and preschoolers.
The injury is not
often seen in children older than 5 or 6 years. This is because as children
grow, their bones harden and their ligaments tighten and thicken. This helps
keep the elbow in place.
Girls are slightly
more likely than boys to suffer from nursemaid's elbow.
Causes of nursemaid's elbow
Nursemaid's elbow can
occur if you pull on the child's forearm or hand, especially if the arm is
twisted. It doesn't take much effort to get hurt. The most common cause of nursemaid's
elbow is a pull-type injury.
Nursemaid's elbow may
occur if you:
- 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
Nursemaid's elbow symptoms
The main symptom of a
dislocated elbow is pain when the child moves the arm. In fact, the
babysitter's elbow can be quite painful. However, there are no swelling,
bruising, or other signs of serious injury.
To reduce pain, the
child usually refuses to use the hand and keeps it still at the side. The elbow
can be slightly bent, and the palm turned towards the body. You should not try
to straighten your arm or bring your elbow back into place. If you do this, the
child will fight back and you may cause more serious damage.
Severe pain, even
without swelling, can be a sign of a fracture. Call your doctor if your child
has elbow pain.
Nursemaid's elbow treatment
Treatment depends on
the child's age and general health. The doctor will examine the child and make
sure that the bone is not broken. X-rays are usually not required to diagnose
this.
Over-the-counter pain
relievers such as acetaminophen or ibuprofen may be prescribed. Be sure to ask
your healthcare provider for the correct dose for your child. Never give
aspirin to a child under 12 years of age.
The doctor will use a
technique called a "reduction maneuver" to bring the elbow back into
the correct position. This method is also called "reduction".
In this method, the
doctor holds the child's wrist and elbow. Then the doctor gently moves the arm
in a certain way until the elbow is in place. You may hear a "click"
when this happens.
The contraction
maneuver takes only a few seconds. This can be done in the doctor's office.
The procedure may be
temporarily painful. The baby will probably cry for a few seconds.
Most children can use
their hand without pain after 10-15 minutes. But some children may be afraid to
use their hand because they remember that it used to hurt. If this happens,
your doctor may recommend pain medication and then monitoring for the next hour
to make sure the child is moving the arm.
X-rays are usually
not needed. X-ray results for a person with nursemaid's elbow are normal. But
an x-ray can be done if the child does not move the arm after reduction.
Sometimes the first
attempt to compress does not work. It may take two or more times to return the
elbow to the correct position. Surgery is rarely required.
Nursemaid's elbow can
sometimes be the result of child abuse. A child abuse investigation may be
conducted if there are other indications that the child is being abused, or if
it is happening to an older child.
Nursemaid’s elbow prevention
As your child grows,
his ligaments become stronger. Thus, it becomes less likely that tugging on the
child's arms will cause the nursemaid's elbow. Until then, you can avoid
babysitter's elbow if you follow these tips:
- Do not lift a child up by the arms or hands. Lift the child under the arms instead.
- Do not tug or jerk a child's hand or arm.
- Never swing a child by the hands or arms.
Kids who have had nursemaid's elbow are more likely to get it again in the future.