{"id":581,"date":"2024-02-21T14:46:59","date_gmt":"2024-02-21T14:46:59","guid":{"rendered":"https:\/\/pricklypearpediatrics.com\/?p=581"},"modified":"2024-04-24T19:53:01","modified_gmt":"2024-04-24T19:53:01","slug":"nursemaids-elbow","status":"publish","type":"post","link":"https:\/\/pricklypearpediatrics.com\/index.php\/2024\/02\/21\/nursemaids-elbow\/","title":{"rendered":"The Nursemaid&#8217;s Elbow"},"content":{"rendered":"\t\t<div data-elementor-type=\"wp-post\" data-elementor-id=\"581\" class=\"elementor elementor-581\">\n\t\t\t\t<div class=\"elementor-element elementor-element-cfc0b6e e-flex e-con-boxed e-con e-parent\" data-id=\"cfc0b6e\" data-element_type=\"container\">\n\t\t\t\t\t<div class=\"e-con-inner\">\n\t\t\t\t<div class=\"elementor-element elementor-element-29876bf elementor-widget elementor-widget-heading\" data-id=\"29876bf\" data-element_type=\"widget\" data-widget_type=\"heading.default\">\n\t\t\t\t<div class=\"elementor-widget-container\">\n\t\t\t\t\t<h2 class=\"elementor-heading-title elementor-size-default\">The Nursemaid's Elbow<\/h2>\t\t\t\t<\/div>\n\t\t\t\t<\/div>\n\t\t\t\t<div class=\"elementor-element elementor-element-484397b elementor-widget elementor-widget-image\" data-id=\"484397b\" data-element_type=\"widget\" data-widget_type=\"image.default\">\n\t\t\t\t<div class=\"elementor-widget-container\">\n\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t<img fetchpriority=\"high\" decoding=\"async\" width=\"800\" height=\"534\" src=\"https:\/\/pricklypearpediatrics.com\/wp-content\/uploads\/2024\/02\/AdobeStock_283107113-1024x683.jpeg\" class=\"attachment-large size-large wp-image-582\" alt=\"\" srcset=\"https:\/\/pricklypearpediatrics.com\/wp-content\/uploads\/2024\/02\/AdobeStock_283107113-1024x683.jpeg 1024w, https:\/\/pricklypearpediatrics.com\/wp-content\/uploads\/2024\/02\/AdobeStock_283107113-300x200.jpeg 300w, https:\/\/pricklypearpediatrics.com\/wp-content\/uploads\/2024\/02\/AdobeStock_283107113-768x512.jpeg 768w, https:\/\/pricklypearpediatrics.com\/wp-content\/uploads\/2024\/02\/AdobeStock_283107113-1536x1024.jpeg 1536w, https:\/\/pricklypearpediatrics.com\/wp-content\/uploads\/2024\/02\/AdobeStock_283107113-2048x1365.jpeg 2048w\" sizes=\"(max-width: 800px) 100vw, 800px\" \/>\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t<\/div>\n\t\t\t\t<\/div>\n\t\t\t\t<div class=\"elementor-element elementor-element-5790b2b7 elementor-widget elementor-widget-text-editor\" data-id=\"5790b2b7\" data-element_type=\"widget\" data-widget_type=\"text-editor.default\">\n\t\t\t\t<div class=\"elementor-widget-container\">\n\t\t\t\t\t\t\t\t\t<p style=\"font-weight: 400;\">\u00a0 \u00a0 \u00a0 \u00a0 \u00a0 It\u2019s a fairly common scenario for parents: you are walking through a store holding your child\u2019s hand, when all of the sudden something super interesting catches your child\u2019s eye. Maybe it\u2019s a very colorful unicorn stuffed animal with a rainbow horn; or maybe it\u2019s a toy truck that lights up, has a horn to honk, and drives around on its own; or maybe it\u2019s a bag of Cheetos. All of the sudden, the child tries to jerk away from you and run towards the super exciting object. You keep a hold of their hand and try to keep them moving along with you, because you have things to do and no we are not coming home with another toy, but your child pulls away even harder. And then\u2026they start crying in pain, holding their arm, and after that refuse to use the arm. They almost certainly have a nursemaid\u2019s elbow and your day just got more interesting.<\/p><h2 style=\"font-weight: 400;\"><strong>What is a nursemaid\u2019s elbow?<\/strong><\/h2><p style=\"font-weight: 400;\"><br \/>The official name for a nursemaid\u2019s elbow is subluxation of the radial head. The radial head is the top part of the radius bone, which is one of the two bones in your forearm. There is a ligament that wraps around the radial head called the annular ligament. In children, especially between the ages of 1-5 years, this ligament is soft and flexible, and therefore can slip out of place in the right conditions. If the child\u2019s arm is put in traction: \u00a0for example, you are pulling on your child\u2019s hand while their arm is outstretched and they are pulling away from you \u2013 the annular ligament can slip out of place, causing pain. A nursemaid\u2019s elbow is not a fracture or broken bone of any kind. The best way to think of it is a \u201cpulled elbow.\u201d<\/p><p style=\"font-weight: 400;\"><strong>How does it happen?<\/strong><\/p><p style=\"font-weight: 400;\">The most common scenarios that lead to a nursemaid\u2019s elbow are:<\/p><ul><li>holding onto a child\u2019s hand as they are pulling away from you<\/li><li>a toddler who\u2019s hand you are holding who throws themselves to the ground in a tantrum<\/li><li>you are walking with your child holding their hand and they start to fall so your reflexively jerk your hand up to try to catch them<\/li><li>picking up a child by then hands or wrists or swinging them by the hands or wrists<\/li><li>Kids playing together and one child pulls hard on the other child\u2019s hand\/arm<\/li><\/ul>\t\t\t\t\t\t\t\t<\/div>\n\t\t\t\t<\/div>\n\t\t\t\t<div class=\"elementor-element elementor-element-271a87f gallery-spacing-custom elementor-widget elementor-widget-image-gallery\" data-id=\"271a87f\" data-element_type=\"widget\" data-widget_type=\"image-gallery.default\">\n\t\t\t\t<div class=\"elementor-widget-container\">\n\t\t\t\t\t\t\t<div class=\"elementor-image-gallery\">\n\t\t\t<div id='gallery-1' class='gallery galleryid-581 gallery-columns-2 gallery-size-medium_large'><figure class='gallery-item'>\n\t\t\t<div class='gallery-icon portrait'>\n\t\t\t\t<a data-elementor-open-lightbox=\"yes\" data-elementor-lightbox-slideshow=\"271a87f\" data-elementor-lightbox-title=\"NursemaidselbowPI\" data-e-action-hash=\"#elementor-action%3Aaction%3Dlightbox%26settings%3DeyJpZCI6NTgzLCJ1cmwiOiJodHRwczpcL1wvcHJpY2tseXBlYXJwZWRpYXRyaWNzLmNvbVwvd3AtY29udGVudFwvdXBsb2Fkc1wvMjAyNFwvMDJcL051cnNlbWFpZHNlbGJvd1BJLmpwZyIsInNsaWRlc2hvdyI6IjI3MWE4N2YifQ%3D%3D\" href='https:\/\/pricklypearpediatrics.com\/wp-content\/uploads\/2024\/02\/NursemaidselbowPI.jpg'><img decoding=\"async\" width=\"515\" height=\"685\" src=\"https:\/\/pricklypearpediatrics.com\/wp-content\/uploads\/2024\/02\/NursemaidselbowPI.jpg\" class=\"attachment-medium_large size-medium_large\" alt=\"\" srcset=\"https:\/\/pricklypearpediatrics.com\/wp-content\/uploads\/2024\/02\/NursemaidselbowPI.jpg 515w, https:\/\/pricklypearpediatrics.com\/wp-content\/uploads\/2024\/02\/NursemaidselbowPI-226x300.jpg 226w\" sizes=\"(max-width: 515px) 100vw, 515px\" \/><\/a>\n\t\t\t<\/div><\/figure><figure class='gallery-item'>\n\t\t\t<div class='gallery-icon landscape'>\n\t\t\t\t<a data-elementor-open-lightbox=\"yes\" data-elementor-lightbox-slideshow=\"271a87f\" data-elementor-lightbox-title=\"Nursemaid&#039;s Elbow\" data-e-action-hash=\"#elementor-action%3Aaction%3Dlightbox%26settings%3DeyJpZCI6NTg0LCJ1cmwiOiJodHRwczpcL1wvcHJpY2tseXBlYXJwZWRpYXRyaWNzLmNvbVwvd3AtY29udGVudFwvdXBsb2Fkc1wvMjAyNFwvMDJcL1BpY3R1cmUxLnBuZyIsInNsaWRlc2hvdyI6IjI3MWE4N2YifQ%3D%3D\" href='https:\/\/pricklypearpediatrics.com\/wp-content\/uploads\/2024\/02\/Picture1.png'><img decoding=\"async\" width=\"768\" height=\"675\" src=\"https:\/\/pricklypearpediatrics.com\/wp-content\/uploads\/2024\/02\/Picture1-768x675.png\" class=\"attachment-medium_large size-medium_large\" alt=\"\" srcset=\"https:\/\/pricklypearpediatrics.com\/wp-content\/uploads\/2024\/02\/Picture1-768x675.png 768w, https:\/\/pricklypearpediatrics.com\/wp-content\/uploads\/2024\/02\/Picture1-300x264.png 300w, https:\/\/pricklypearpediatrics.com\/wp-content\/uploads\/2024\/02\/Picture1-1024x900.png 1024w, https:\/\/pricklypearpediatrics.com\/wp-content\/uploads\/2024\/02\/Picture1.png 1239w\" sizes=\"(max-width: 768px) 100vw, 768px\" \/><\/a>\n\t\t\t<\/div><\/figure>\n\t\t<\/div>\n\t\t<\/div>\n\t\t\t\t\t\t<\/div>\n\t\t\t\t<\/div>\n\t\t\t\t\t<\/div>\n\t\t\t\t<\/div>\n\t\t<div class=\"elementor-element elementor-element-b7591e9 e-flex e-con-boxed e-con e-parent\" data-id=\"b7591e9\" data-element_type=\"container\">\n\t\t\t\t\t<div class=\"e-con-inner\">\n\t\t\t\t<div class=\"elementor-element elementor-element-15cc27d elementor-widget elementor-widget-text-editor\" data-id=\"15cc27d\" data-element_type=\"widget\" data-widget_type=\"text-editor.default\">\n\t\t\t\t<div class=\"elementor-widget-container\">\n\t\t\t\t\t\t\t\t\t<p style=\"font-weight: 400;\"><strong>How can you tell?<\/strong><br \/>If one of the above- described scenarios has occurred, and your child starts crying, holds their arm still next to themselves and refuse to use the arm to grab a toy\/food or give a high five, a nursemaid\u2019s elbow is possible. There is usually no swelling, bruising, or visible deformity of the affected arm. The child may complain of elbow pain, arm pain, or wrist pain. Usually after a few minutes, the initial pain of the injury subsides and as long as no one attempts to touch or move the arm, the child will stop crying and hold their arm still but go along with their day.<\/p><p style=\"font-weight: 400;\"><strong>What do you do?<\/strong><\/p><p style=\"font-weight: 400;\">You will want to call and schedule an appointment with your child\u2019s doctor, preferable same day if possible. If you can\u2019t get an appointment within 24 hours, then you may need to head to urgent care. Typically, this does not need an ER visit, unless your child\u2019s hand or arm appears very swollen, discolored (blue\/purple), or they are in a lot of pain. Do not try to move the arm around yourself prior to getting it checked out by the doctor.<\/p><p style=\"font-weight: 400;\"><strong>What does the doctor do?<\/strong><\/p><p style=\"font-weight: 400;\">The truth is, most Pediatricians are happy to see a child with a nursemaid\u2019s elbow walk through the door for 2 reasons: 1) we know how to fix it and it is quite simple 2) we can make the child feel better almost instantly. We of course will thoroughly examine the arm to check for swelling, bruising, or other signs of a different type of injury. We will want to hear the whole story of how it happened. And if it sounds and looks like a straightforward nursemaid\u2019s elbow, we will do a reduction procedure which takes about 10 seconds and involves just moving the child\u2019s arm in a certain way. The child usually does cry during the procedure because they don\u2019t want that arm touched or moved at all. They may cry for a few minutes afterwards. But within 10-20 minutes after the procedure, they should start to move their arm around just like normal! As if nothing ever happened! Our favorite way to test to see if they procedure is successful is to offer a high five, a sucker or a popsicle and make them use the injured arm to take to prize or give the high five.<\/p><p style=\"font-weight: 400;\"><strong>Do they need any tests?<\/strong><\/p><p style=\"font-weight: 400;\">If there is no history of trauma to the arm and no swelling or bruising, and if the story is classic for nursemaid\u2019s elbow, they we will not usually order an x-ray. If the story is a bit more concerning (they fell from a distance and landed on the arm, they sustained a hard blow to the arm, etc.) or there is bruising, significant swelling, or pain in an atypical location, then we may recommend that they have an x-ray done to make sure there is no fracture. After successful reduction of a nursemaid\u2019s elbow as described above, there are typically no follow up tests needed.<\/p><p style=\"font-weight: 400;\"><strong>Can it happen again?<\/strong><\/p><p style=\"font-weight: 400;\">Once a child has had a nursemaid\u2019s elbow, they are a little bit more likely to get another one (reoccurrence rates are about 20-30%). If a child has several episodes of nursemaid\u2019s elbow, their doctor may teach the parents the reduction technique to try at home so that we can save you frequent trips to the doctor. By the age of 5 years, the annular ligament is much stronger and unlikely to slip out of place anymore. So, after your child turns 5, you don\u2019t need to worry about the possibility of a nursemaid\u2019s elbow anymore.<\/p><p style=\"font-weight: 400;\"><strong>Can it happen again?<\/strong><\/p><p style=\"font-weight: 400;\">Once a child has had a nursemaid\u2019s elbow, they are a little bit more likely to get another one (reoccurrence rates are about 20-30%). If a child has several episodes of nursemaid\u2019s elbow, their doctor may teach the parents the reduction technique to try at home so that we can save you frequent trips to the doctor. By the age of 5 years, the annular ligament is much stronger and unlikely to slip out of place anymore. So, after your child turns 5, you don\u2019t need to worry about the possibility of a nursemaid\u2019s elbow anymore.<\/p><p style=\"font-weight: 400;\"><strong>How do we avoid it?<\/strong><\/p><p style=\"font-weight: 400;\">In some cases, a nursemaid\u2019s elbow is unavoidable because toddlers are tricky and unpredictable. Some things that you can keep in mind that will help to prevent a nursemaid\u2019s elbow from occurring are:<\/p><ol><li>Avoid picking a child up by the hands and wrists. Instead, lift from under the upper arms, armpits, or around the trunk.<\/li><li>Avoid sudden upward jerking movements on a child\u2019s arm.<\/li><li>If you are holding a child\u2019s hand and they start to throw a tantrum: throw themselves down or are pulling away, let go of their hand (if you are in a safe place where they can\u2019t run into danger).<\/li><li>Don\u2019t swing your child by the hands\/wrists (see pic above).<\/li><li>Avoid forcefully pulling off jackets\/coats (can get caught around the wrist and pull outwards on the arm.<\/li><\/ol><p style=\"font-weight: 400;\"><strong>In Summary:<\/strong><\/p><p style=\"font-weight: 400;\">Nursemaid\u2019s elbow is a common elbow injury in kids between the age of 1-4 years, occurring in approximately 20,000 kids per year and in most of these cases, it was an <strong>accident<\/strong>. Parenting is hard and I like to try to remind parents that they are doing a good job! Try not to blame yourself or feel guilty. Toddlers are tricky and emotional and FAST. If you think that your child may have a nursemaid\u2019s elbow, just call your child\u2019s doctor. We are here to help, not to judge. Most of the time, the kids are back to normal within a few minutes of their doctor\u2019s visit and will not remember that this injury occurred. Hang in there and keep up the good work!<\/p><p>\u00a0<\/p><p>Resources:\u00a0<\/p><p><a href=\"https:\/\/youtu.be\/1vR51sf5j5o?si=WGU8rEl6oeVCa1nh\">Video about nursemaid&#8217;s elbow<\/a><\/p><p style=\"font-weight: 400;\"><strong>~ Dr. Webb<\/strong><\/p>\t\t\t\t\t\t\t\t<\/div>\n\t\t\t\t<\/div>\n\t\t\t\t\t<\/div>\n\t\t\t\t<\/div>\n\t\t<div class=\"elementor-element elementor-element-95a9cab e-con-full e-flex e-con e-parent\" data-id=\"95a9cab\" data-element_type=\"container\">\n\t\t\t\t<div class=\"elementor-element elementor-element-41c65e3 elementor-widget elementor-widget-image\" data-id=\"41c65e3\" data-element_type=\"widget\" data-widget_type=\"image.default\">\n\t\t\t\t<div class=\"elementor-widget-container\">\n\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t<img loading=\"lazy\" decoding=\"async\" width=\"1\" height=\"1\" src=\"https:\/\/pricklypearpediatrics.com\/wp-content\/uploads\/2023\/10\/IMG_8014.heic\" class=\"attachment-large size-large wp-image-514\" alt=\"\" \/>\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t<\/div>\n\t\t\t\t<\/div>\n\t\t\t\t<\/div>\n\t\t\t\t<\/div>\n\t\t","protected":false},"excerpt":{"rendered":"<p>Dr. Webb explains what a nursemaid&#8217;s elbow is, how it is treated, and some tips to try to prevent it from occurring. <\/p>\n","protected":false},"author":2,"featured_media":0,"comment_status":"closed","ping_status":"open","sticky":false,"template":"","format":"standard","meta":{"footnotes":""},"categories":[23],"tags":[27,24,25],"class_list":["post-581","post","type-post","status-publish","format-standard","hentry","category-childhood-injuries","tag-injury-prevention","tag-nursemaids-elbow","tag-toddlers"],"yoast_head":"<!-- This site is optimized with the Yoast SEO plugin v26.4 - https:\/\/yoast.com\/wordpress\/plugins\/seo\/ -->\n<title>The Nursemaid&#039;s Elbow - Prickly Pear Pediatrics<\/title>\n<meta name=\"description\" content=\"When should you suspect a nursemaid\u2019s elbow? 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