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Pulled Elbow

(Nursemaid’s Elbow; Radial Head Subluxation; Partially Dislocated Elbow)

Definition

Three bones come together at the elbow. One bone makes the upper arm and two make the lower arm. One of the lower arm bones may slip out of place at the elbow. This is called a pulled elbow. It is a common elbow injury in young children.
A pulled elbow can be easily treated. It does not lead to long-term problems.
The Elbow Joint
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Causes

Ligaments help to keep your bones in place. These ligaments are loose in young children. Bones are also not fully formed in young children. These factors make it easier for the bones to slip out of place.
An elbow pull happens with a sudden jerk, tug, or blow to the elbow. In children, even a small amount of force may cause the injury.

Risk Factors

These types of injuries are most common in children 1-6 years of age.
Actions that may increase the risk of dislocation include:
  • Pulling a child up by the hands
  • Swinging a child by their arms
  • Jerking a child’s arm
  • Breaking a fall with the arm
  • Rolling over in an awkward way
Children that have had a pulled elbow are more likely to dislocate their elbow again.

Symptoms

Symptoms may include:
  • Pain at elbow right after pulling or trauma to elbow
  • Child refuses to use arm
  • Arm is kept close to child’s side
  • Child resists straightening the arm

Diagnosis

Your doctor will ask about your child’s symptoms. A physical exam will be done.
The diagnosis will most likely be done during the physical exam. Your doctor may also look for signs of broken bone such as swelling and tenderness.

Treatment

The doctor will be able to move the bone back in place.
For some children the pain will go away once the bone is back in place. Your child may also be able to easily move their arm within a few minutes.
For other children, it may take a few tries to move the bone back into position. Treatment may also be delayed in younger children with mild pain. In these cases, your child may continue to have discomfort after the bone is moved back into place. To make your child more comfortable, your doctor may recommend:
  • Medications such as acetaminophen or ibuprofen.
  • Sling to rest the elbow for a few days
  • Applying ice to the elbow

Prevention

Some dislocations can be prevented. To help reduce your child’s chance of a partial dislocation:
  • Avoid jerking or tugging your child’s arm
  • Avoid swinging your child by their arms or wrists
  • Lift young children from under their arms

RESOURCES

Health Children http://www.healthychildren.org

Kids Health http://kidshealth.org

CANADIAN RESOURCES

About Kids Health http://www.aboutkidshealth.ca

Health Canada http://www.hc-sc.gc.ca

References

Nursemaid’s elbow. American Academy of Pediatrics website. Available at: http://www.healthychildren.org/English/health-issues/conditions/orthopedic/Pages/Nursemaids-Elbow.aspx. Updated October 10, 2012. Accessed October 29, 2012.

Nursemaid’s elbow. Boston Children’s Hospital website. Available at: http://www.childrenshospital.org/az/Site1082/mainpageS1082P0.html . Accessed October 29, 2012.

Nursemaid’s elbow. Nemours Kidshealth website. Available at: http://kidshealth.org/parent/medical/bones/nursemaid.html . Accessed October 29, 2012.

Radial head subluxation. DynaMed website. Available at: https://dynamed.ebscohost.com/about/about-us . Updated February 27, 2012. Accessed October 29, 2012.

Revision Information

  • Reviewer:
  • Review Date: 06/2013
  • Update Date: 06/24/2013
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