Nursemaid’s elbow is a partial dislocation at the elbow joint. It happens when a ligament in the elbow joint becomes pinched. A ligament is a band of tissue that connects bone (Picture 1). Nursemaid’s elbow is also known as a radial (RAY-dee-al) head subluxation (sub-lux-A-shun). It is most often caused when the child is picked up by his or her hands. It can also happen if the child pulls his hand or arm out of an adult’s hand. The injury occurs most often in children under age 6.
Usually, there is no redness or swelling on the arm. The child may complain of pain in the wrist, elbow or forearm, but cannot point to any one area of severe pain. He will often avoid using the injured arm. Sometimes he will hold the arm limply at his side. Do not force his arm to move, that may cause more damage in the joint. It is important to tell your doctor if you think your child has fallen on his elbow or had a blow to the arm. Also, tell the doctor any details of the injury.
The doctor will use one or more methods to put the bone back into place. After the ligament is put back into place, the child may still be afraid to move the arm. We may ask you to offer your child a toy or drink to see if he can move the arm without difficulty. The doctor may suggest that you give the child medicine such as Tylenol, if needed, to help with pain or tenderness. Usually, within a few minutes the child will be able to move the arm better. Sometimes the doctor will use a splint for a short time. In the first few weeks after the injury, there is an increased risk of the elbow dislocating again. It is important to manage your child’s activities to prevent this from happening.
It is important to talk with others who care for your child about the right way to pick him up:
Nursemaid's Elbow (PDF)
HH-I-203 1/98, Revised 4/11 Copyright 1998-2011, Nationwide Children’s Hospital