Nursemaid's elbow is a dislocation of the radius bone from the elbow joint (a.k.a. - subluxation of the radial head).  It most commonly occurs when a young child's arm is pulled abruptly.  After the injury, the child refuses to use the arm and holds the arm down by her side.  There is minimal tenderness when the joint is touched.  Treatment involves a maneuver called a "reduction."  This may be done by a physician.  X-rays are typically not necessary and not helpful.  Once a nursemaid's elbow is fixed (or "reduced") the child can return to normal function within a few hours.

   

How does a nursemaid's elbow occur?

This is a common injury and may occur when an adult is holding the child's hand and then one of the following happens: the adult lifts the child quickly, the adult pulls the child out of danger, or the child drops suddenly (throwing a temper tantrum for example). The injury may also occur if the child has a tight grip on something that is pulled away from the body suddenly.

How is a nursemaid's elbow diagnosed?

The story provided by the family or child is helpful, especially if it is known that the arm was pulled abruptly prior to the injury.  The child often holds the arm to her side, with the palm of the hand facing towards the back and the child refuses to use the arm due to discomfort.  The ebow joint and arm are not tender when touched, and there is minimal (if any) swelling.  X-rays are usually not necessary and often appear normal despite the dislocation.

How is nursemaid's elbow treated?

A physician performs a maneuver called a "reduction."  This is done by rotating and flexing the arm with the elbow held by the examiner.  The examiner can feel a "click" as the radial head pops back into place.  This causes brief discomfort, however the child should recover quickly and begin using the arm within a few minutes.

Will nursemaid's elbow happen again?

Children who have had a nursemaid's elbow can have a repeat injury.  Attempts should be made to avoid pulling on the arm if possible.