Nursemaid's elbow (radial head subluxation) is an injury in which a bone of the elbow joint is pulled out of place and gets stuck in that position. This injury is common in young children. It often happens when you lift or pull the child by 1 or both arms. The injury commonly occurs when a parent or caregiver is trying to keep the child out of harm’s way. This might be grabbing a child who is about to step out into the street. Sometimes a playmate will tug hard enough on the arm to cause this injury.
This injury happens because the ligaments in the elbow can be weak in some young children. Your child’s health care provider can usually fix this fairly easily by gently moving the bone back into place. But the injury can happen again if the arm is pulled again. Ligaments get stronger by 5 or 6 years of age. Nursemaid’s elbow will usually not occur after that.
After the bone is put back into position, it usually takes about 30 to 60 minutes before the child will start using that arm normally again. In some cases, it may take up to 24 hours. If your child is not using the arm normally by 24 hours, they may have other injuries. Your child may need X-rays or other tests to find out what they are.
Home care
Follow these guidelines when caring for your child at home:
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If all symptoms get better before you leave the facility, your child doesn’t need any more treatment.
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If your child is still having arm pain, a splint and sling may be put on. Leave this in place until the next scheduled exam, or as advised by your child’s provider.
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Give your child pain medicines as directed by the provider. Don't give your child aspirin unless told to by a provider.
Prevention
Until your child is at least 5 years old, this injury may occur again with any type of lifting or pulling on the arm. To prevent it from happening again:
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Don’t lift or pull your child by the arm. Hold your child under the arms to lift.
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Don’t swing your child by holding their hands or arms.
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Teach siblings and friends not to tug or pull on your child’s arms.
Follow-up care
Follow up with your child’s provider as advised. If a splint was put on, follow up for a repeat exam within the next 24 hours, or as advised.
When to contact your child's doctor
Contact your child’s provider right away if:
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The pain gets worse or your child continues to cry.
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You see swelling or bruising occurs around the elbow.
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Your child isn’t using the arm normally by the next day.
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