An extremely common pediatric injury is something called a “nursemaid’s elbow.” When a child falls onto her arm, or the arm is pulled upward by a parent or another child (even if the force is trivial), the annular ligament of the radius can temporarily slip out of position. A child will then refuse to use the arm, because moving the elbow is painful. The arm is usually held close to the body in a bent-elbow position, with the palm resting against the belly. When evaluating a child for a possible nursemaid’s elbow, check the body from the clavicle to the wrist. If none of the bones hurt when you push on them, then the child probably has a nursemaid’s elbow.
The good news about this condition is it can be easily fixed at home! On many occasions, I’ve talked parents through the procedure over the phone, and they usually have success.
Recently my family recorded a video with instructions for fixing a nursemaid’s elbow at home. Just click on the link below to access the video.
If you think your child has a nursemaid’s elbow, you can follow these steps at home:
- Have your child sit in another adult’s lap.
- Grasp your child’s injured right hand with your left hand, as though you were going to shake hands (Conversely, if the injury is on the other side, then you should grasp your child’s left hand with your right hand).
- Hold the area just above your child’s elbow with your free hand to help stabilize the elbow.
- Use your hand-shake hand to turn your child’s palm up to the ceiling.
- In quick succession, straighten your child’s elbow, almost to the point that you’re hyperextending the elbow; then rapidly flex the elbow by bending it, bringing the hand you’re holding close to the child’s shoulder.
- When the radial head successfully relocates, you may feel a “pop” with the hand that is stabilizing the elbow; this is a good sign.
Your child may cry during the procedure, but within a few minutes she should calm down and start using the arm normally again. Because the change is so dramatic, fixing a nursemaid’s elbow is one of the most satisfying things a pediatrician or parent can do!