What Does a Nursemaid Have to do with the Elbow?

If your child has had a nursemaid's elbow before, you're probably aware of what I'm about to write about next.  However, I also want to help any parents whose kids have experienced this problem if it happens again - you can try and fix it yourself.

A nursemaid's elbow is the dislocation of one of the bones in the elbow called the radius.  When a bone is dislocated it slips out of it's normal position.  This occurs when a child (usually between the ages of 2-5) gets pulled up forcefully by the hand or wrist.  It can also occur with a fall or from being swung by one arm.  When the dislocation occurs, the child will not want to use that arm and will complain of pain or point to his or her elbow, forearm, or wrist.  Sometimes you can see elbow swelling as well.

During the 3-4 weeks following a nursemaids elbow, it is more likely to occur again.  A nursemaid's elbow is rare in kids over 5 years old because the joints and structures around the elbow are stronger.  On occasion a nursemaid's elbow will reduce (or fall back into place) on its own.  You'll know that this has happened because your child will start using his or her arm again.  But most of the time it requires a certain maneuver to be performed in order to get the elbow in the right position.

The first time your child experiences a nursemaid's elbow it is better for a healthcare provider to perform the maneuver, but if your child has repeated bouts of nursemaid's elbow, you can try to put it back in place yourself.  You can flex the elbow and rotate the forearm so that the palm is facing upward.  Again, it is important that your healthcare provider discusses this with you and indicates that it is ok for you to try the maneuver in the instance that your child sustains another nursemaid's elbow.

Rarely are there complications from a nursemaid's elbow, but they can occur, especially if it goes untreated.  You can prevent this from happening - avoid lifting a child by one arm only (from the wrist or hand).  Lift from under the arms, from the upper arm, or from both arms.  Do not swing children by the hand or forearm.  You can swing your child in circles, just provide support under the arms and hold the upper body next to yours!

Rachel Brewer, MD