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Nursemaid's Elbow

  • Overview

    Nursemaid's elbow occurs when the radius (one of the bones in the forearm) slips out of place from where it normally attaches to the elbow joint. It is a common condition in children younger than 4 years of age. It is also called dislocated elbow, pulled elbow, slipped elbow, or toddler elbow. The medical term for nursemaid's elbow is radial head subluxation.

    • Nursemaid's elbow is a temporary condition with no permanent damage.
    • Usually seen in children aged 1-4 years, but has been seen in infants aged 6-12 months.
    • Rarely seen in children older than 6 years because by this time, a child's bones are larger and more well-defined.

    How Boston Children's Hospital approaches nursemaid's elbow.

    Because young children who experience nursemaid's elbow may be in a lot of pain, it is important to Children's that your child is kept calm and reassured throughout diagnosis and treatment.

  • In-Depth

    What causes nursemaid's elbow?

    A sudden pulling force on your child's arm, particularly if the arm is extended and twisted, can cause nursemaid's elbow. This can happen easily in the hustle and bustle of everyday parenting.

    • Lifting your child by the hand
    • Swinging your child while holding him or her by the hand
    • Pulling your child's arm through the sleeve of a jacket
    • Catching your child by the hand to prevent him or her from falling
    • Pulling your child by the arm to hurry them up
    • If an infant rolls over himself or herself

    What are the symptoms of nursemaid's elbow?

    The following are the most common symptoms of nursemaid's elbow. However, each child may experience symptoms differently. Symptoms may include:

    • immediate pain in the injured arm; if your child can talk, he or she may describe pain in the elbow, along with pain in the wrist and/or shoulder
    • refusal or inability to move the injured arm
    • anxiety due to the sudden pain

    The symptoms of nursemaid's elbow may resemble other conditions or medical problems. Always consult your child's physician for a diagnosis.

  • Tests

    How does a doctor know if my child has nursemaid's elbow?

    Your child's doctor will perform a physical exam of your child's arm, looking for places where the arm may be tender (particularly in the head of the radius). Unless your doctor suspects another injury, X-rays will not be needed.

  • Specific treatment for nursemaid's elbow will be determined by your child's physician based on the following:

    • your child's age, overall health, and medical history
    • the extent of the condition
    • your child's tolerance for specific medications, procedures, or therapies
    • expectations for the course of the condition
    • your opinion or preference.

    Treatment may include

    • acetaminophen (for pain), as directed by your child's physician
    • prompt medical treatment while providing reassurance for your child.

    Once the elbow has sustained this type of injury, it is more likely to recur. If this happens again, call your child's physician or return to the emergency department for further evaluation and treatment. Most children outgrow the tendency for nursemaid's elbow by the age of 5.

    Preventing nursemaid's elbow

    • Lift young children from under the arms
    • Never lift young children by the hands or wrists
    • Never swing toddlers by the arms or wrists
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