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NURSEMAIDS ELBOW

Nursemaids elbow happens when a ligament in the elbow joint becomes pinched. A ligament is a band of tissue that connects bone (Picture 1). Nursemaids elbow is also known as a radial (RAY-deeal) head subluxation (sub-lux-A-shun). It is often caused when one of the forearm bones the radius is jerked suddenly. The injury occurs most often in children under age 6.

SIGNS OF NURSEMAIDS ELBOW


Usually, there is no redness or swelling on the arm. The child may complain of pain in the wrist, elbow or forearm, but cant point to any one area of severe pain. The child with nursemaids elbow will often avoid using the injured arm. Sometimes he will hold the arm limply at his side. Its important to tell your doctor if you think your child has fallen on his elbow or had a blow to the arm. Also tell the doctor any details of the injury.

Picture 1 The normal elbow joint.

TREATMENT
The doctor will use one or more methods to put the bone back into place. After the ligament is put back into place, the child may still be afraid to move the arm. We may ask you to offer your child a toy or drink to see if he can move the arm without difficulty. The doctor may suggest that you give the child medicine such as Tylenol if needed to help with pain or tenderness. Usually, within a few minutes the child will be able to move the arm better. Sometimes the doctor will use a splint for a short time. See the Helping Hand Splints, HH-II-3. If the elbow has gone untreated for a long time, there may be swelling. An ice pack may be put on to reduce the swelling. HH-I-203 2/03
Copyright 1998-2003, Nationwide Childrens Hospital

Nursemaids Elbow Page 2 of 2

PREVENTION
Its important to talk with others who care for your child about the right way to pick her up: Use both hands and grasp the child carefully under the arms around the trunk. Never lift a child by the arms (Picture 2). Teach people who care for your child to watch carefully if the child pulls away from them while they are holding his hand. Other children should not be allowed to grab your child by the hand to pull him along. If you suspect a nursemaids elbow, its important to have your child treated right away to avoid the swelling that makes treatment more difficult and painful.

If you have any questions, be sure to ask your doctor or nurse.

Picture 2 The right way to lift a child.

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