Nursemaid’s elbow is one of the most common orthopedic injuries seen in children between the ages of 1-3 years. It is not, as some think, a dislocation of the elbow, or rather a slip of one of the ligaments in the elbow over a bone. This occurs because children’s ligaments are loose and the bones are not fully formed yet.
Nursemaid elbow may occur if:
- the child has an incident in which the extended arm is pulled
- a child is falling and the individual holding the hand doesn’t let go
- the child is swinging while being held by the hands
- the child’s arms are pulled through sleeves of jackets
- after a fall
What to do if nursemaid’s elbow occurs:
After a nursemaid’s elbow, the child will hold his or her arm in an extended position with the hand facing toward the body. The child will usually not be in pain unless you or the child tries to move the elbow. It is important so seek attention right away so that the doctor can do a reduction. This is almost always accomplished without the need for an anesthetic and only takes a few seconds. A pop may be heard or felt, and then the child can use the arm immediately, very often without any discomfort at all. There is, however, a risk of reoccurrence.
Tips to reduce the risk of nursemaid’s elbow:
- pick up the child under the armpits, not by the hands or wrists
- don’t swing the child by his hands or wrists
- avoid jerking your child’s arm, even when you’re irate or in a hurry
- teach your child to not break his fall with his hands, which is the natural reaction
- be aware of how your baby rolls over in his crib
- instruct caregivers on the proper care of your child
The parent should make sure that the child can use the arm at most 30 minutes after the reduction. If not, then there may be a different diagnosis, including a fracture, joint infection, tumor, or osteomyelitis.
To make an appointment for your child, please call:
Dr. Jack Choueka, Director of Upper Extremity Surgery, 718-283-7362
Dr. David Edelstein, Upper Extremity Surgeon, 718-283-8927
Dr. Mara Karamitopoulos, Orthopedic Pediatrician, 718-283-6520