Nursemaid Elbow or Radial Head Subluxation

Nursemaid elbow is a condition that is found in preschool age children. Nursemaid elbow or radial head subluxation is generally an accident that occurs when pulling the child's arm. Playfully swinging the child by the arms, helping them out of the bathtub, or catching them by the arm when they fall are common ways that nursemaid elbow occurs in young children.

Nursemaid elbow is most common in children between the ages of 1 and 4 years old. However, radial head subluxation can happen at younger ages. Nursemaid elbow is a temporary condition, which is caused by tissue being pulled between the bones of the elbow. The bones of a young child are still forming at preschool age and are soft. The yet undeveloped radius bone does not have the lip to lock the radial head into the elbow joint. This allows the annular ligament to slide between and become trapped between the bones causing nursemaid elbow.

When nursemaid elbow occurs, the child will cry out in pain and hold their arm close to the body with forearm slightly turned inward. The child will favor the arm letting it hang by their side with limited use. Some children will appear unaffected within a few hours, occasionally complaining of pain during overuse of the arm or during growth spurts.

It is best to contact your physician when nursemaid elbow occurs. The doctor can easily put the bones back in place with minimal pain for the child. In some cases, this does not work and a splint may be required for the child. However, when the nursemaid elbow does not affect the child on a regular basis the doctor may choose to let the child outgrow the condition. As the child, ages the bones will grow and the annular ligament tightens allowing the bones to slide back into place on their own. If this does not occur by age five, other options will be explored.

To prevent your child from getting nursemaid elbow, avoid any sudden jerking to the arm. Do not swing your child by the arms, avoid the monkey bars, or other activities that could cause the child's arm to jerk or pull. In the real world, we know this is not always possible. It is quite common and can occur during everyday events such as holding your child's hand while walking and they trip and fall. Your child having nursemaid elbow does not mean you are a bad parent.