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Nursemaid’s Elbow

Be peace of mind on your Child Nursemaid’s Elbow. Call us +65 6471 2744 for immediate attention (24 Hours) / SMS to: +65 9235 7641

Nursemaid’s elbow is a partial dislocation of the elbow, which occurs when the lower part of the arm (forearm) slips out of its normal position at the elbow joint.

The injury is also called radial head dislocation.

Causes of Nursemaid’s Elbow

Nursemaid’s elbow is a common condition in young children and generally affects children under age 5. The injury occurs when a child is pulled up too hard by the hand or wrist. It is often seen after someone lifts a child up by one arm up. (For example, when trying to lift the child over a curb or high step.) Swinging a young child from the arms while playing can also cause this injury.

When the injury occurs, the child usually begins crying immediately and refuses to use the arm. The child may hold the arm so that is slightly bent (flexed) at the elbow and pressed up against the belly (abdominal) area. The child will move the shoulder, but not the elbow. Some children stop crying as the immediate pain goes away, but continue to refuse to move the elbow.

Once the elbow dislocates, it is likely to do so again, especially in the 3 or 4 weeks following the injury.

Nursemaid’s elbow does not usually occur after age 5. By this time, a child’s joints and surround structures are stronger, and the child is less likely to be in a situation where this injury might occur. However, in some cases, the injury can occur in older children or adults, usually from a fracture of the forearm.

Symptoms of Nursemaid’s Elbow

  • Immediate crying
  • Complaints of elbow pain
  • Refusing to use the arm that is injured
  • Holding elbow slightly bent at the elbow
  • Holding the lower part of the arm against the belly area (abdomen)
  • Moving arm at shoulder but not elbow

If you think your child has nursemaid’s elbow:

  • DO NOT move the child without first splinting the arm.
  • DO NOT try to straighten the arm or change its position.

Apply an ice pack to the elbow. Splint the injured arm in the position in which you found it. Keep the area both above and below the injured elbow from moving, including the shoulder and the wrist, if possible.

Take the child to the doctor’s office or emergency room.

Exams and Tests of Nursemaid’s Elbow

The health care provider will examine the child.

The child will be unable to rotate the arm at the elbow so that the palm is up and will have trouble bending (flexing) the elbow all the way.

Treatment of Nursemaid’s Elbow

The doctor will fix the dislocation by gently flexing the elbow and rotating the forearm so that the palm is facing upward. DO NOT try to do this yourself as you may harm the child.

In some cases of frequently recurring nursemaid’s elbow, your health care provider may teach you how to attempt to correct the problem yourself. See your health care provider for assistance.

Outlook (Prognosis) of Nursemaid’s Elbow

If nursemaid’s elbow remains untreated, it may result in permanent inability to fully move the elbow. With treatment, there is usually no permanent damage.

Possible Complications of Nursemaid’s Elbow

In some cases, the child may have problems that limit movement of the arm.

When to Contact a Medical Professional of Nursemaid’s Elbow

Call us (+65 6471 2744 – 24 Hours) if you suspect your child has a dislocated elbow or refuses to use an arm.

Prevention of Nursemaid’s Elbow

Avoid lifting a child by one arm only, either from the wrist or hand. Lift from under the arms, from the upper arm, or from both arms. Do not swing children by the hand or forearm. To swing a young child in circles, provide support under the arms and hold the upper body next to yours.

Be peace of mind on your Child Nursemaid’s Elbow. Call us +65 6471 2744 for immediate attention (24 Hours) / SMS to: +65 9235 7641

Elbow Dislocation

Elbow dislocations are the second most common dislocations in adults, behind shoulder dislocations. The elbow is a very stable joint and so it requires a lot of force to dislocate it.

What are the symptoms?

  • Extreme pain
  • Obvious deformity (more so in complete dislocations)
  • Bruising on the inside and outside of the elbow
  • Swelling

A dislocated elbow occurs usually as a result of a fall, or a direct blow and often involves an associated fracture of the Radius, Humerus or Ulna. The most common mechanism involves falling onto an outstretched hand, with the arm away from the body and the elbow being forceably flexed on contact. There is usually also a twisting movement. This results in a posterior dislocation which accounts for up to 90% of all elbow dislocations. In a posterior dislocation the Ulna or the Radius (sometimes both!) moves backwards.

When the elbow is dislocated posteriorly this can be either partial (also known as a subluxation) or complete. With a partial dislocation the joint surfaces are separated by a small distance and usually reduce (return to their normal position) either instantly or with very little help. A complete dislocation occurs when the joint surfaces are considerably separated and can require a manual reduction (by a Doctor).

Dislocations usually involve damage to surrounding structures, most often the ligaments of the elbow joint, fractures to the Radius or Ulna or damage to the nerves or blood vessels which pass close to the elbow joint which may become trapped (pinched) by the moving bone.

Treatment

What can the athlete do?

  • Visit a Doctor or Hospital immediately
  • Apply ice or cold therapy to the elbow
  • Put the elbow in a sling to support it
  • DO NOT attempt to ‘pop it back in’ yourself! This can cause further damage

What can a professional do?

  • A Doctor will assess your arm for swelling, deformity and movement
    The lower arm and hand should also be checked for warmth and colour. A cold, white or blue tinged hand can indicate that a nerve or blood vessel has been trapped or damaged
  • An MRI or X-ray may be performed (sometimes before, sometimes after reduction)
    In a complete dislocation (or a partial dislocation which has not reduced itself) a reduction will be performed to return the elbow back to the correct position
  • This involves manipulating the elbow into a position which forces the bones back to their natural position.
  • The elbow is rested in a sling for between 1 and 3 weeks dependant on the extent of damage
    A rehabilitation program should then be followed.

Rehabilitation

  • Following a period of immobilisation, gentle mobility exercises should be commenced to increase the range of motion at the elbow joint.
  • Once range of motion is close to normal, strengthening exercises for the muscles surrounding the elbow should begin.
  • Damage to surrounding ligaments shoud also be treated as described here
    Taping or a support can be used on a return to sport

Get your Elbow Dislocation treated today, Call +65 6471 2744 for appointment / Email: info@boneclinic.com.sg