Nursemaid's elbow

Nursemaid's elbow, also called radial head subluxation, means that the radius has pulled away from its normal position. (The radius is one of two long bones in the lower arm, or forearm.) The ligament that supports the radial bone then slips into the elbow joint. When this happens, the radial bone can't move back into its normal place.

The radius connects to the elbow joint at one end. The other end connects into the wrist joint.

Symptoms of nursemaid's elbow include:

• Refusal to move the arm. Your child may keep the arm dangling down the side of their body. Sometimes the dangling arm turns slightly inward (pronates).
• Crying. Your child may cry from the pain and because they are scared.
• Pain anywhere between the hand and shoulder.

Medical attention is needed if your child has symptoms of nursemaid's elbow.

Your doctor usually suspects the injury from your report of how it happened, your child's symptoms, and results of the physical exam. The doctor will feel different areas of the arm and try to move it into certain positions. Usually X-rays of the elbow are not needed. But your doctor may order one to find out if your child has a more serious injury.

Nursemaid's elbow should be treated by a doctor.

Allow your child to keep the arm in the most comfortable position until you get medical help.

You can also put an ice pack on your child's elbow. But if your child resists, don't insist. Be careful not to move your child's arm from the most comfortable position.

A doctor will move your child's arm to free the trapped ligament and put the end of the radius back into its normal position. Usually, children start to feel better right away. But sometimes the pain lingers for a bit. It may take from 30 minutes to a few hours for your child to move the arm normally.

The doctor may place a sling or splint on your child's arm until all pain is gone. If your child can move the arm normally without pain soon after treatment, a sling or a splint is not needed.

Although your child heals quickly, they have a greater chance of having nursemaid's elbow again, especially in the first few weeks after being injured.

• Be careful in how you hold or lift your child. When you lift or swing your child, hold them under the arms. This includes when you lift your child up onto a higher surface (such as a sidewalk or equipment at a playground).
• Use care when walking with your child as you hold their hand or lower arm (forearm). If a child pulls back or resists, stop. Don't pull your child. Wait until your child is ready to go with you without resistance. If this is not possible, pick up your child.

Be sure to follow your doctor's directions on how to care for your child after nursemaid's elbow.