Nursemaid’s elbow is considered as a prevalent injury during early childhood. It is oftentimes referred to as a pulled elbow since it occurs once the elbow of a child is pulled or partly displaced. This injury is medically known as radial head subluxation.
Since the bones and muscles of young children are still developing, it usually takes minimal force to pull the bones of the elbow partly out of place, thus making the injury quite common. This injury typically occurs often in children ages 1-4 years old but can also occur any time from birth up to 6-7 years old.
Even though the injury can cause initial pain, the doctor can easily reset the elbow in order to quickly relieve any discomfort and restore arm movement.
What is nursemaid’s elbow?
Nursemaid’s elbow usually occurs once there is partial separation of the radiocapitellar joint. Since the ligaments in young children are not yet fully formed, even a mild force on the joint can cause it to shift or partly dislocate. The annular ligament encloses the radius and can become wobbly in some children which can lead to a recurrent nursemaid’s elbow.
Possible causes
Nursemaid’s elbow typically occurs when a parent or caregiver holds the hand or wrist and pulls suddenly on the arm to avoid a dangerous scenario or to help a child onto a curb or step. The injury can also occur while playing when an older child or family member swings the child around holding just the hands or arms.
This injury is rarely caused by a fall. In case the child damages the elbow when tumbling onto an extended hand or straight on the elbow, it can cause a broken bone instead of nursemaid’s elbow.
Symptoms
Since moving the affected arm can cause pain, the main indication of nursemaid’s elbow can be observed in which the child will grasp the affected arm still on his/her side and avoid bending the elbow or use the arm.
Diagnosing nursemaid’s elbow
The doctor will make a diagnosis based on how the injury was sustained and the manner in which the child holds his/her arm. Even though an X-ray is not needed to confirm a diagnosis, the doctor might order one in order to ensure that there are no broken bones.
Treatment
In most cases, the doctor will move the bones gently back into position which is called as reduction. The doctor will hold the wrist or forearm of the child and turn the hand so that it faces palm up. While applying pressure close to the top of the radius bone with his/her thumb, the doctor will steadily bend the elbow. There is a faint click or pop once the joint returns into place.
Even though the child can experience some discomfort during reduction, the pain subsides once the bones are restored back into place. Most children can start to use the arm within minutes after the procedure but it can take up to 24 hours for the pain to fully resolve and regain normal use of the elbow. With the help of pain management measures that you can learn in a course on first aid, you can provide comfort to the child.