Nursemaid's Elbow
Dr Malak from Bambini Pediatrics writes; "About once a month, a toddler from our practice develops nursemaid's elbow. Typically, this happens when a parent pulls a straying child to safety or lifts / swings a tot by the arms.
It doesn't take a whole lot of force to sublux (partially dislocate) an elbow in the 1 to 4 year-old age group. Girls, perhaps due to estrogen effect, are a bit more susceptible; and the left arm is a little more common than the right.
Typically, the child will cry for a few minutes immediately and calm down, but then they will not move the forearm -- holding it in pronation (palm facing down).
When we see kids in the office with a suspected nursemaid elbow, we generally do not order an x-ray before attempting reduction unless the history includes a fall rather than traction or there is notable tenderness, bruising, or swelling on exam. If reduction fails and there is no improvement within a day, we also check x-rays."
Kidshealth.org writes:
"Nursemaid's elbow can happen with just a small amount of force. For example:
Pulling a child up by the hands can put stress on the elbows. Never pick up a toddler or infant by the hands or wrists, but lift under the armpits.
Swinging a toddler by holding the hands or wrists can put stress on the elbow joint and should be avoided.
Jerking an arm when pulling a toddler along or quickly grabbing his or her hand can make the ligament slip. Always be gentle when taking a child by the hand.
Breaking a fall by reaching an arm out for protection can overextend the elbow, causing the ligament to slip.
Rolling over in an awkward way in a crib, bed, or on the floor can cause nursemaid's elbow in infants and very young children.
As kids get older, the ligaments tighten. Most won't get nursemaid's elbow after they turn 5 years old, though it can happen up to age 6 or 7.
It's important to know that kids who get nursemaid's elbow might get it again. So be mindful of the risks and don't pull, tug, or swing your child by the arms or hands and be sure to tell all caregivers to do the same."
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