What Is a Nursemaid’s Elbow?
The elbow joint has three bones: the humerus, the ulna, and the radius. Nursemaid’s elbow, also known as “pulled elbow,” happens when the ligament that holds the radius in place slips, causing the end of the radius to move out of position. This makes the elbow partially dislocated.
Long ago, nursemaids who cared for children were thought to have caused this injury by pulling on their arms, hence the name “nursemaid’s elbow.” Doctors call it radial head subluxation.
Who Does It Affect?
- Nursemaid’s elbow happens most often in toddlers and preschoolers aged 2 to 5 years when their ligaments are still developing.
- It rarely occurs in children over 6 years old, whose bones are stronger and more mature.
- The condition Is temporary and doesn’t cause permanent harm.
Causes of Radial Head Subluxation
A nursemaid’s elbow can occur if you pull or twist a child’s lower arm or hand, even with just a little force. The most common cause is pulling on the arm. Nursemaid’s elbow might happen if you:
- Grab a child’s hand to prevent a fall.
- Lift a child by their hands or wrists.
- Help a child put their arm through a jacket sleeve.
- Swing a child by their arms or hands.
- Pull on a child’s arm to hurry them along.
Symptoms of Nursemaid’s Elbow
If you didn’t see the injury happen, you might not notice the symptoms of nursemaid’s elbow right away. At first, children will cry because of the pain, but they might not complain much after that. There won’t be any swelling. Watch out for the following signs in your child:
- Cries or shows pain right after their arm or hand was pulled.
- Feels pain in their wrist and/or shoulder.
- Doesn’t want to move their arm below their shoulder.
- Holds one arm with the other hand.
- Keeps their arm straight or slightly bent and close to their body.
- Doesn’t want to turn their palm.
Nursemaid’s Elbow Reduction Methods
Fixing a nursemaid’s elbow (radial head subluxation) is a careful procedure that should be done by an experienced orthopedic doctor or another well-trained medical provider. There are two main ways to do it:
- Supination-Flexion Method
This method involves the doctor gently holding the child’s wrist and elbow. Then, the doctor turns the forearm outward (supinates) and bends the elbow to fix the problem. - Hyperpronation Method
In this approach, the doctor bends the child’s elbow to a 90-degree angle with one hand. On the other hand, the doctor turns the wrist inward (hyperpronates) to put the bone back in place.
The hyperpronation method is often easier and less upsetting for the child. However, both techniques require a lot of skill and experience to be done safely.
Ending Note
Only trained orthopedic specialists should try the earlier-mentioned nursemaid’s elbow reduction methods. If done wrong, fixing it could cause more harm. People with this problem should always get help from a skilled professional.
Visit Dr. Cusick at Michael C. Cusick, M.D. Our board-certified orthopedic surgeon specializes in shoulder and elbow surgery to provide the best possible treatments for your injuries. Call us at (713) 794-3599 anytime.
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