How to Know If Your Child Has a Nursemaid’s Elbow
Key takeaways:
A nursemaid’s elbow is a common injury in young children. It is a partial dislocation of the elbow. It happens when a ligament slides out of place and into the joint.
This can happen when a child is swung or pulled by their arm. Afterward, children usually don’t want to use their arm. They hold it against their bodies with the elbow in a slightly bent position.
A nursemaid’s elbow can be put back in place with a simple and quick maneuver by a trained medical professional.
A nursemaid’s elbow is a common injury in children ages 6 months to about 4 years. In fact, as many as 20% of arm injuries in children are a nursemaid’s elbow. It can occur very easily, and doesn’t require a lot of trauma or force. So you may not even realize your child is hurt until they refuse to use their arm normally. We will go over exactly what a nursemaid's elbow is, how to recognize it, and what to do if you suspect your child has it.
What is a nursemaid's elbow?
In technical terms, a nursemaid’s elbow is a minor dislocation involving one of the forearm bones. More specifically, it occurs when a ligament slides over the top of the radius bone at the elbow.
Let’s take a look at the elbow joint to better understand what this means. The elbow is where the bones of the forearm join with the bone of the upper arm. Ligaments act like rubber bands that hold your bones together. When that rubber band is stretched, it can slide over the top of the bone and get stuck in the joint. This is what happens with a nursemaid’s elbow.
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What causes a nursemaid’s elbow?
A nursemaid elbow can happen easily — with very little force or injury. It most often happens when the elbow is fully extended (straight), and something or someone pulls on the hand or wrist.
For example, this can happen when a caretaker swings a small child by their hands. Or when they pull the child out of the way from an oncoming car. Because there is rarely an obvious trauma, caretakers can be confused why a child suddenly refuses to move their arm. Even babies can do this to themselves simply by rolling over during a nap.
This injury is typically only seen in kids under 4 years old. This is because as kids grow older, the elbow ligament becomes stronger and does not easily slide out of place.
Symptoms of nursemaid’s elbow
In some cases, it may be immediately obvious that there is an injury to the elbow. But a nursemaid’s elbow is usually more subtle than that. And most caretakers do not know the child is injured until they notice the signs and symptoms afterward.
Children with a nursemaid’s elbow often:
Refuse to move their affected arm.
Hold their affected elbow slightly bent and close to their body.
Cry if you try to move their hurt arm.
Do not want to bend the elbow, but they can still move their fingers and wrist.
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It can also be hard for the child to point out exactly where they are feeling pain. Even though the injury is in the elbow, they may complain of wrist or forearm pain.
How is a nursemaid’s elbow diagnosed?
Most caretakers will seek medical attention when a child is not moving their arm. This may be a pediatrician’s office, emergency room, or urgent care. A provider can typically make the diagnosis based on a report of what happened or by simply examining the child.
An X-ray is not needed to make the diagnosis. But if there is any question of a different injury — like a break in the bone — they may recommend imaging.
How is a nursemaid's elbow treated?
The treatment for a nursemaid’s elbow is easy. A trained provider can quickly ‘reduce’ the dislocation. This is the technical term for slipping the ligament back over the bones and into its proper place.
This reduction takes seconds. It is sometimes so quick and subtle that you might not realize that your provider has already fixed it. And the good news is that the child may not realize it either.
After the reduction, it can take some time for your child to realize it no longer hurts when they bend their elbow. Many children are ready to move their arms normally within 10 minutes, and 90% within half an hour. For some, it may be a little sore for a few hours afterward, but generally a dose of ibuprofen does the trick.
The bottom line
It can be alarming if you notice your child suddenly stops using their arm. If your child is holding their elbow or complains of new pain in their arm, it is possible they have a nursemaid’s elbow. Rest assured this is a common injury, and there is a relatively quick and easy fix. After a simple reduction maneuver, your child will be as good as new and back to their normal, playful self.
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References
Nardi, N. M., et al. (2021). Nursemaid elbow. StatPearls.
Wong, K., et al. (2016). Radial head subluxation: Factors associated with its recurrence and radiographic evaluation in a tertiary pediatric emergency department. The Journal of Emergency Medicine.
