Nursemaid's Elbow

Nursemaid's elbow, also known as radial head subluxation, is a common injury that occurs in young children, typically under the age of 4.

Causes and Risk Factors

The condition occurs when the radius bone in the forearm partially dislocates from the elbow joint. This can happen when a child is lifted or pulled by the hand, causing the forearm to twist and the radial head to slip out of place.

Risk factors for nursemaid's elbow include:

• Age: Children under 4 years old are most susceptible
• Lifting or pulling a child by the hand
• Sudden twisting or bending of the forearm
• Playful activities that involve lifting or swinging a child

Symptoms

Common symptoms of nursemaid's elbow include:

• Pain in the elbow and forearm
• Refusal to move the affected arm
• Limping or holding the affected arm still
• Crying or fussing when the arm is moved

Diagnosis

Diagnosis of nursemaid's elbow is typically made through a physical examination and medical history. A healthcare provider may:

• Examine the child's elbow and forearm for tenderness and swelling
• Check for limited mobility or pain when moving the arm
• Ask about the circumstances surrounding the injury

Treatment

Treatment for nursemaid's elbow usually involves a simple reduction technique, where the healthcare provider:

• Gently flexes the child's wrist and forearm
• Applies gentle pressure to the radial head to guide it back into place
• May use a quick and firm motion to reduce the subluxation

Pain relief, such as acetaminophen or ibuprofen, may be recommended to help manage discomfort.

Prevention

To prevent nursemaid's elbow, caregivers can take the following precautions:

• Lift children carefully, avoiding twisting or bending of the forearm
• Avoid pulling or jerking a child by the hand
• Use proper lifting techniques when picking up a child

Prognosis and Complications

Most cases of nursemaid's elbow resolve quickly with treatment, and complications are rare. However, repeated subluxations can increase the risk of future injuries.

In some cases, nursemaid's elbow may be a sign of an underlying condition, such as a fracture or ligament sprain. If symptoms persist or worsen, further evaluation and treatment may be necessary.