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Nursemaid’s Elbow is a common injury of early childhood that results in subluxation of the annular ligament due to a sudden longitudinal traction applied to the hand.
Diagnosis can be made clinically with a child that holds the elbow in slight flexion with pain and tenderness localized to the lateral aspect of the elbow.
Treatment is usually closed reduction with either a supination or a hyperpronation technique.
Treatment depends on your child’s age and overall health. The doctor will examine the child and make sure the bone is not broken. X-rays are not usually necessary to diagnose this.
Over-the-counter pain medicine may be given. Make sure you ask your health care provider for the correct dose for your child.
The doctor will use a method called a “reduction maneuver” to put the elbow back into the correct position. This method is also called a “reduction.”
In this method, the doctor holds the child’s wrist and elbow. The doctor then carefully moves the arm in a specific way until the elbow pops back into place. You may hear a “click” when this happens.
A reduction maneuver only takes a few seconds. It may be done in the doctor’s office.
The procedure can be briefly painful. The child will probably cry for a few seconds.
Most kids can use the arm without pain within 10 to 15 minutes. But some kids may be afraid to use the arm because they remember that it hurt before. If this happens, your doctor may recommend pain medicine and then observation for the next hour to make sure the child moves the arm.
X-rays are usually not needed. X-ray results are normal in someone with nursemaid’s elbow. But X-rays may be taken if the child does not move the arm after a reduction.
Sometimes, the first attempt at reduction does not work. It may take two or more times to put the elbow back into the correct position. Surgery is rarely needed. If your doctor can’t put the elbow bone back into place, they’ll call an orthopedic specialist.
Nursemaid’s elbow may sometimes be the result of child abuse. A child abuse investigation may be done if there are other signs that the child is being abused or if it occurs in an older child.