Nursemaid's Elbow (Pulled Elbow)

What is nursemaid's elbow?

Nursemaid's elbow is also called subluxation of the radial head or a pulled elbow. It is an injury to a ligament (a strong band of tissue) that keeps the two bones of the forearm in the correct place.

The two bones in the forearm are the radius and the ulna. The radius is on the thumb-side of the forearm. The upper end of the radius is called the radial head. The radial head is kept in place by a ligament called the annular ligament. When the annular ligament is torn, a part of it slides upward and gets trapped in the elbow joint. This is very painful.

This injury is uncommon after age 3.

What is the cause?

Nursemaid's elbow is caused by of a strong force on the elbow. This often occurs when an adult pulls on a child's arm or the child falls away from an adult while being held by the arm.

How is it treated?

Your healthcare provider will move the bone and the ligament back to their correct positions. This is an easy correction done at your healthcare provider's office. The ligament needs time to heal, so be very gentle with your child's arm. X-rays of the elbow are usually not necessary.

Once the ligament and the radial head are returned to their proper place, the child usually can begin to use his arm again within a few minutes. A few children have a small amount of swelling or pain in the joint. Regular doses of ibuprofen for a few days will help with the swelling and pain. Check with your healthcare provider before you give any medicine that contains aspirin or salicylates to a child or teen. This includes medicines like baby aspirin, some cold medicines, and Pepto Bismol. Children and teens who take aspirin are at risk for a serious illness called Reye's syndrome. Nonsteroidal anti-inflammatory medicines (NSAIDs) may cause stomach bleeding and other problems. These risks increase with age. Read the label and take as directed. Unless recommended by your healthcare provider, do not take for more than 10 days.

How can I prevent this from happening again?

Once an elbow has been injured, it is more likely that it will happen again in the future. Do not lift your child by the arm or pull hard on your child's arm.

When should I call my child's healthcare provider?

Call during office hours if:

• Your child does not use the arm or seems to be in a lot of pain.
• You are worried that someone intentionally hurt your child.