What is Nursemaid’s elbow?

Nursemaid’s elbow, also known as radial head subluxation, is a dislocation of the radial head from where it usually sits caused by a sudden pull on the extended pronated forearm, such as by an adult tugging on an uncooperative child or by swinging the child by the arms during play.

Nursemaid’s elbow also known as the pulled elbow, is a normal incident occurring in childhood. Even the pulled elbow is the most common childhood elbow injury. Children aged 1 to 4 years most often experience it, although infants and older children can also complain.

 Nursemaid's Elbow Singapore

Why Nursemaid’s elbow happen in young children?

This injury occurs in smaller children because the ligaments (elastic binding that holds the bones together) are in a loose position and the bone is not fully formed. This makes the bone easier to move from its original place. As the child grows larger, the ligaments become tighter and thicker, the bones are also widening and hardening, so the risk of nursemaid’s elbow becomes lessened.

Causes of Nursemaid’s elbow

  • Swinging a child with his arm. Any type of swinging motion by holding a hand or wrist may put pressure on the elbow joint and should be avoided.     
  • Pull the child up by holding both his hands. Pulling a hand or arm can put pressure on the elbow. Do not raise toddlers or babies by holding their hands or wrists. Holding underarms is the safest way to pick up a small child.     
  • Stopping child’s arm. Drawing the toddler’s arm as it walks or too quickly pulls his hand can jerk off the arm so as to cause the radial head to shift. You need to remember to always be careful when holding the child’s hand when walking.     
  • Roll over in an unnatural way. Sometimes rolling on the bed or on the floor can cause nursemaid’s elbow in babies and small children.    
  • Hold with arms when falling. The natural response to falling is to stretch out your arm to protect yourself. Elbows can work too hard when this action occurs, resulting in a shift in the radial head.

Symptoms of Nursemaid’s elbow

The symptoms of nursemaid’s elbow can be seen with the appearance of the following sign:     

  • No swelling or deformation. A child with a nursemaid’s elbow may at first glance be invisible because subluxation does not cause the arm to undergo a clear or swollen form of change in the elbow.     
  • The child refuses to use his arm. Your child can not use an injured arm without feeling pain. Therefore, he placed the arm in a position of silence and straight on the side of his body, or with a slight indentation on the elbow. When the arm is at rest, the child experiences only mild pain and discomfort.

If an injury to the arm or elbow causes pain, this can be a sign of a broken or bruised bone. Nursemaid’s elbow usually does not cause the child too much pain. It does make it difficult for parents to distinguish between nursemaid’s elbow and broken bones, which is why you need to bring your baby to a doctor for examination.

Treatments for Nursemaid’s elbow

Treatment for nursemaid’s elbow is through reduction. This procedure is very fast and takes only a few seconds. Children are usually asked to sit on the lap of a parent when doctors try to reduce subluxation in bone. During this procedure, the arms are in a straight position and bent upward with rapid movement. The doctor will hear the sound like a small explosion, which indicates the bone has returned to its original place

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