Dislocated elbow - children

Alternative names
Pulled elbow; Nursemaid’s elbow

Definition
Nursemaid’s elbow is a partial dislocation of the elbow joint, making it difficult and painful to move the joint.

Causes, incidence, and risk factors

Nursemaid’s elbow is a common condition in young children and generally affects children under five. It occurs when someone pulls a child too hard by the hand or wrist.

Nursemaid’s elbow is often seen after a parent lifts a child by one arm up a curb or high step. The child generally begins to cry immediately and refuses to use the arm. The child hold’s the arm in a slightly flexed position (slightly bent at the elbow) and holds the forearm against the abdomen. The child will move the shoulder, but not the elbow.

Often, the child will stop crying as the immediate pain subsides, but will continue to refuse to move the elbow.

Symptoms

     
  • immediate crying  
  • elbow pain  
  • refusal to use the affected arm  
  • slight flexion of elbow  
  • forearm rests lightly against abdomen  
  • child will move arm at shoulder

Signs and tests
The child will be unable to rotate the arm at the elbow so that the palm is up, or bend the elbow (flex) fully.

Treatment
The doctor will reduce the dislocation by rotating the forearm so that the palm is up and gently flexing the elbow all the way. Note: Do NOT try to do this yourself as you can do more harm than good. See your health care provider for assistance.

Expectations (prognosis)
If nursemaid’s elbow remains untreated, it may result in permanent inability to fully move the elbow. With treatment, there is usually no permanent damage.

Complications

     
  • permanent limitation of motion

Calling your health care provider
Call your health care provider if you suspect your child has a dislocated elbow or refuses to use an arm.

Prevention
Avoid lifting a child by one arm only (from the wrist or hand). Lift under the arm, from the upper arm, or both arms at a time.

Johns Hopkins patient information

Last revised: December 8, 2012
by Armen E. Martirosyan, M.D.

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All ArmMed Media material is provided for information only and is neither advice nor a substitute for proper medical care. Consult a qualified healthcare professional who understands your particular history for individual concerns.