Children, Orthopedics September 29, 2020

Nursemaid’s elbow: A common elbow injury among young children

David Lazarus, MD

Pediatric Orthopedic Surgery

Children love when mom and dad hold them from their wrists and swing them around. However, what many don’t realize is that simply lifting your child by the wrist over the curb can result in a common elbow injury called a nursemaid’s elbow, or a pulled elbow.

“It is called a pulled elbow because kids pulled by their hands may have sudden pain and be afraid to move their elbow,” said David E. Lazarus, MD, pediatric orthopedic surgeon. “It is a partial dislocation of the elbow that is fairly common in young children.”

How do I know my child has nursemaid’s elbow?

Nursemaid’s elbow is most common in kids between ages 1 and 4. Although scary for a parent, it is a problem that can be easily diagnosed and treated. X-rays aren’t needed to diagnose a pulled elbow if the history makes sense, but sometimes an X-ray is recommended to rule out a fracture around the elbow. If the pain is from a fall, accident, or if there is any swelling, it is unlikely to be nursemaid’s elbow and needs further workup.

How is nursemaid’s elbow treated?

Fortunately, the treatment is relatively simple. However, the diagnosis should be confirmed by a doctor before treatment. The treatment consists of this two-step maneuver:

1. Hold the child’s arm gently with the elbow extended and turn the hand facing the ceiling or the child’s face.
2. Gently flex the elbow completely toward the shoulder. If the doctor or parent places a hand on the elbow, he or she will often feel a small click.

“The child should feel much better and have no activity restrictions moving forward,” said Dr. Lazarus. “While there is a good chance it may happen again, parents should rest assured their child will likely grow out of the injury reoccurrence over time.”