Nursemaid's Elbow

Nursemaid’s elbow is a common elbow injury in young children, typically occurring when the forearm is suddenly pulled or tugged. The injury happens when a ligament slips out of place, causing pain and limited use of the affected arm. Although it can be alarming, nursemaid’s elbow is usually easy to treat when addressed promptly.

Orthopaedic Associates of Wisconsin provides expert evaluation and treatment for pediatric elbow injuries, helping children return to normal activity quickly and safely.

What Is Nursemaid’s Elbow?

Nursemaid’s elbow, also known as radial head subluxation, occurs when the radial head partially slips out from under a supporting ligament in the elbow. This injury most commonly affects children between the ages of one and four, as their ligaments are still developing.

The condition often occurs during everyday activities and does not typically involve a fall or direct impact.

Causes of Nursemaid’s Elbow

Nursemaid’s elbow is usually caused by a sudden pulling motion on a child’s arm. Common scenarios include:

• Lifting or pulling a child by the hand or wrist

• Swinging a child by the arms

• A sudden tug when preventing a fall

• Pulling an arm through clothing

This injury is accidental and can happen during routine caregiving activities.

Symptoms of Nursemaid’s Elbow

Children with nursemaid’s elbow may:

• Hold the affected arm still or slightly bent

• Avoid using the arm

• Experience pain when the arm is moved

• Show minimal swelling or bruising

Because symptoms can appear suddenly, the injury may be distressing for both children and parents.

Diagnosing Nursemaid’s Elbow

Diagnosis is usually made through a physical examination and review of how the injury occurred. Imaging is rarely required unless there is concern for fracture or another injury.

Prompt evaluation helps confirm the diagnosis and allows for immediate treatment.

Treatment for Nursemaid’s Elbow

Treatment typically involves a simple, gentle maneuver performed by a medical professional to guide the ligament back into place. This reduction often provides immediate relief, and most children begin using their arm normally within minutes.

In most cases:

• Surgery is not needed

• Immobilization is not required

• Long-term complications are rare

Parents may be advised on ways to help prevent recurrence.

When to See a Specialist

If a child suddenly refuses to use their arm or experiences elbow pain after a pulling injury, medical evaluation is recommended. Early treatment can relieve discomfort quickly and prevent unnecessary imaging or prolonged pain.