Nursemaid’s Elbow :: Nationwide Children's Hospital

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Nursemaid's Elbow

Nursemaid’s elbow is a partial dislocation at the elbow joint. Nursemaid’s elbow is also known as a radial (RAY dee al) head subluxation (sub lux AY shun).  It happens when a ligament in the elbow joint becomes pinched.  A ligament is a band of tissue that connects bone (Picture 1).  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. 

Signs of Nursemaid’s Elbow

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.  The child will often avoid using the injured arm.  Sometimes he or she will hold the arm limply at his side.  Do not force the arm to move, that may cause more damage in the joint.  It is important to tell your child’s medical practitioner if you think your child has fallen on his elbow or had a blow to the arm.  Include all the details of the injury.

 
Image of a normal elbow joint

Treatment

The practitioner will use one or more methods to put the bone back into place.  After the bone 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 or she can move the arm without difficulty.  The practitioner 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 practitioner will use a splint for a short time.  In the first few weeks after the injury, there is an increased risk of the elbow subluxing again.  It is important to manage your child’s activities to prevent this from happening.

Prevention

Picture 2 - The right way to lift a child.
Image of the correct way to lift a child

It is important to talk with others who care for your child about the right way to pick him up:

 

  • Use both hands and grasp the child carefully under the arms around the trunk (Picture 2).  Never lift a child by the arms. 
  • Teach people who care for your child to watch carefully if the child pulls away from them while they are holding his or her hand.  
  • Other children should not be allowed to grab your child by the hand to pull him or her along.
  • If you suspect a nursemaid’s elbow, it is important to have your child treated right away to avoid the swelling that makes treatment more difficult and painful.

If you have any questions, be sure to ask your doctor or nurse.

Nursemaid's Elbow (PDF)

HH-I-203  1/98, Revised 10/15                       Copyright 1998, Nationwide Children’s Hospital