Nursemaid’s elbow involves the dislocation of the radial head usually caused by a sudden pull on the extended pronation of the forearm such as tugging the child or by swinging the arms of the child during playing. This condition usually happens in children ages 1-3 years and can occur anytime between 6 months to 7 years. The ligaments and joints become strong after 3 years old and nursemaid’s elbow are less likely to happen.
Causes of nursemaid’s elbow
- Pulling up too hard by the hand or wrist
- Lifting a child up by one arm such as lifting a child over a curb or high step.
- Rolling over of an infant into the arm
- Swinging the arm of the child while playing
- Breaking a fall with the arm
- Tugging or pulling the lower arm or hand if the arm is twisted
- Catching a child by the hand to stop a fall.
- Pulling the arm through the sleeve of a jacket
- Forceful pulling of the arm to make him/her walk faster
- Bracing the body with the hand during a fall
- Mild swelling of the affected area
- Difficulty using the arm when held in pronation and flexion
- Limited movements except supination
- Elbow pain
- Deformity, bruising and large swelling of the affected area should be treated immediately.
- Rest the affected area at least for 48 hours.
- Avoid straingthening the arm or changing position.
- Place an ice pack on the affected elbow for at least 10-15 minutes to lessen the swelling, pain and bleeding.
- Use a sling to prevent unnecessary movements and promote fast healing of the condition. When using a sling, a triangle bandage should be used.
- Take the prescribed over-the-counter pain medication such as acetaminophen or ibuprofen to lessen the pain and inflammation. Avoid giving aspirin to children below 12 years old to prevent further damage and worsen the condition.
- After 48 hours if pain still persists, apply heat on the sore muscles. Heat can be in the form of heat pack, heating pad and a warm wet washcloth. Apply for at least 10 minutes as needed. Heat increases the flow of blood in the area and promotes fast healing of the condition. Wrap heat in a towel before placing on the area to prevent burning of the skin and worsen the condition.