What is nursemaid’s elbow in children?

Nursemaid’s elbow is a type of elbow injury. It’s when a forearm bone (radius) slips out of place from where it normally attaches to the elbow joint.

It is a common condition in children younger than age 4. It is also called pulled elbow, slipped elbow, toddler elbow, and radial head subluxation.

What causes nursemaid’s elbow in a child?

A sudden pulling on the hand or forearm can cause nursemaid’s elbow. The radius slips out of the ligament that holds it in place. It can happen when a child rolls over. It can also happen from a fall, arm twisting, or from pulling or swinging a young child by the hand.

What are the symptoms of nursemaid’s elbow in a child?

Each child may feel symptoms a bit differently. But below are the most common symptoms of nursemaid’s elbow:

• Immediate pain in the injured arm

• The child won’t or can’t move the injured arm

• Anxiety

These symptoms may be caused by other health problems. Make sure your child sees their healthcare provider for a diagnosis.

How is nursemaid’s elbow diagnosed in a child?

Your child’s healthcare provider makes the diagnosis by getting your child's health history and doing a physical exam. They may also order an X-ray to check for other injuries, such as a broken bone.

How is nursemaid’s elbow treated in a child?

Treatment will depend on your child’s symptoms, age, and general health. It will also depend on how bad the condition is.

Prompt medical treatment is important to quickly ease your child’s symptoms. Treatment may include:

• Reduction. Your child’s healthcare provider can gently move the arm so the radius bone goes back into place.

• Medicine. Certain medicines, such as acetaminophen or ibuprofen, can help ease pain.

How can I help prevent nursemaid’s elbow in my child?

Once the elbow has sustained this type of injury, it is more likely to happen again. If it does, call your child’s healthcare provider or return to the emergency room for further evaluation and treatment. Most children outgrow the tendency for nursemaid’s elbow by age 5.

To help prevent nursemaid’s elbow:

• Don’t pull or swing your child by the arms or hands.

• Don’t lift your child up by their arms or hands.

Key points about nursemaid’s elbow in children

• Nursemaid’s elbow is a type of elbow injury. It’s when a forearm bone (radius) slips out of place from where it normally attaches to the elbow joint.

• This injury is common in children younger than age 4.

• Activities that suddenly pull the hand or forearm can cause it. These include falls and pulling or swinging a young child by the hand.

• Immediate pain is the most common symptom.

• Your child’s healthcare provider can gently move the radius bone back into place.

Next steps

Tips to help you get the most from a visit to your child’s healthcare provider:

• Know the reason for the visit and what you want to happen.

• Before your visit, write down questions you want answered.

• At the visit, write down the name of a new diagnosis, and any new medicines, treatments, or tests. Also write down any new instructions your provider gives you for your child.

• Know why a new medicine or treatment is prescribed and how it will help your child. Also know what the side effects are and when they should be reported.

• Ask if your child’s condition can be treated in other ways.

• Know why a test or procedure is recommended and what the results could mean.

• Know what to expect if your child does not take the medicine or have the test or procedure.

• If your child has a follow-up appointment, write down the date, time, and purpose for that visit.

• Know how you can contact your child’s provider after office hours, and on weekends and holidays. This is important if your child becomes ill and you have questions or need advice.

Online Medical Reviewers:

• Dan Brennan MD
• Rita Sather RN
• Thomas N Joseph MD