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Nursemaid�s elbow

Definition:

Nursemaid's elbow is a partial dislocation of the elbow joint that makes movement of the arm difficult and painful.



Alternative Names: Pulled elbow; Dislocated elbow - children

Causes, incidence, and risk factors:

Nursemaid's elbow is a common condition in young children and generally affects children under five. It occurs when a child is pulled up too hard by the hand or wrist.

Nursemaid's elbow is often seen after a person lifts a child by one arm up a curb or high step. The child generally begins to cry immediately and refuses to use the arm. The child holds the arm in a slightly flexed position (slightly bent at the elbow) against the abdomen. The child will move the shoulder, but not the elbow.

Often, the child will stop crying as the immediate pain subsides, but will continue to refuse to move the elbow.



Symptoms:
  • Immediate crying and indicating elbow pain
  • Refusing to use the affected arm
  • Holding elbow slightly flexed
  • Holding the forearm against the abdomen
  • Moving arm at shoulder but not elbow


Signs and tests:

The child will be unable to rotate the arm at the elbow so that the palm is up, or to bend (flex) the elbow fully.



Treatment:

The doctor will reduce the dislocation by rotating the forearm so that the palm is up and gently flexing the elbow all the way. DO NOT try to do this yourself as you can do more harm than good. See your health care provider for assistance.



Support Groups:



Expectations (prognosis):

If nursemaid's elbow remains untreated, it may result in permanent inability to fully move the elbow. With treatment, there is usually no permanent damage.



Complications:

A complication of nursemaid's elbow may be permanent limitation of motion.



Calling your health care provider:

Call your provider if you suspect your child has a dislocated elbow or refuses to use an arm.



Prevention:

Avoid lifting a child by one arm only, either from the wrist or hand. Lift from under the arms, from the upper arm, or from both arms.




Review Date: 11/22/2004
Reviewed By: Benjamin D. Roye, M.D., M.P.H., Division of Pediatric Orthopaedics, Beth Israel Medical Center, New York, NY. Review provided by VeriMed Healthcare Network.

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