Nursemaid’s Elbow

What is nursemaid’s elbow?

Nursemaid’s elbow is a common injury of the elbow. It is also known as “pulled elbow”, “slipped elbow” or “toddler elbow”. It is when one of the ligaments at the elbow slips out of place. Your doctor may call this “subluxation of the annular ligament”.

Nursemaid’s elbow occurs in early childhood. This is because the ligaments in young children tend to be a bit loose. Nursemaid’s elbow rarely happens in children older than 5 years because the ligament attachment gets stronger and thicker as children get older.

What are the symptoms of nursemaid’s elbow

Children with nursemaid’s elbow usually do not want to use the affected arm because movement of the elbow is painful. No obvious deformity or swelling will be seen but children with nursemaid’s elbow typically hold the elbow in a certain position: slightly bend and the palm is facing downwards/inwards.

Because each child may express symptoms differently, make sure to see a doctor as it is difficult for parents to tell how bad the injury really is.

What causes nursemaid’s elbow?

Nursemaid’s elbow can occur with little force, for example:

  • Pulling a child up by the hands/forearm
  • Swinging a child
  • Breaking a fall/twisting injury
  • Rolling over awkwardly

How is nursemaid’s elbow diagnosed?

The orthopaedic surgeon will examine the child’s arm/elbow and asks how the injury has happened. Xray might be done to exclude a fracture, but usually no special tests are required.

How is nursemaid’s elbow treated?

Surgery is rarely required. In most cases, a gentle manoeuvre, known as “closed reduction”, can be used to quickly ease the child’s symptoms. This procedure only takes a few seconds. While there might be some discomfort during the manoeuvre itself, children feel much better immediately afterwards. Most patients will be back to normal elbow function within a few minutes.

The prognosis is usually excellent.

What can I do to help prevent the injury in my child?

The best precaution is to avoid any pulling or swinging of your child by the arms/hands. Be mindful to not lift up your child by his/her arms. Sometimes, children might sustain the same injury to the elbow again even when parents try their best to prevent it.

Dr. Gurpal Singh
Consultant Orthopaedic Surgeon

  • Specialist in Orthopaedic Oncology, Joint Replacement and
  • Robotic-assisted Surgery
  • Centre for Orthopaedic Oncology and Reconstructive Surgery
  • Centre for Orthopaedics and Hip and Knee Surgery
  • MBBS (S’pore), MRCSEd, M Med (Ortho)
  • FRCSEd (Ortho), FAMS (Orthopaedics)

Email: gurpal@cfo.com.sg

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Nursemaid’s Elbow

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