What is nursemaid’s elbow. How does nursemaid’s elbow occur. What are the symptoms of nursemaid’s elbow. How is nursemaid’s elbow diagnosed and treated. Can nursemaid’s elbow be prevented. What should parents do if they suspect nursemaid’s elbow.

Understanding Nursemaid’s Elbow: A Common Childhood Injury

Nursemaid’s elbow, also known as pulled elbow or radial head subluxation, is a common and painful injury that primarily affects young children. This condition occurs when the radius bone in the forearm partially dislocates from its normal position at the elbow joint. The term “nursemaid’s elbow” originates from the historical association of this injury with nursemaids who were often blamed for causing it by pulling on children’s arms.

Who is at risk for nursemaid’s elbow?

Nursemaid’s elbow typically affects:

• Children between 1 and 4 years old
• Toddlers and preschoolers with immature ligaments
• Rarely, children older than 6 years

The risk decreases as children grow older and their bones and ligaments become stronger and more mature. While painful, nursemaid’s elbow is generally a temporary condition that does not cause permanent damage when treated promptly.

The Anatomy of Nursemaid’s Elbow: What Happens in the Joint?

To understand nursemaid’s elbow, it’s essential to know the basic anatomy of the elbow joint. The elbow is formed by the connection of three bones:

1. Humerus (upper arm bone)
2. Ulna (inner forearm bone)
3. Radius (outer forearm bone)

In nursemaid’s elbow, the ligament that holds the radius in place at the elbow joint slips, causing the end of the radius to shift out of its normal position. This results in a partial dislocation of the elbow joint.

How does nursemaid’s elbow occur?

Nursemaid’s elbow typically happens when a child’s arm is pulled or yanked suddenly. Common scenarios include:

• Pulling a child’s arm to prevent a fall
• Lifting or swinging a child by the arms
• Jerking a child’s arm to make them walk faster
• A toddler falling onto outstretched arms
• A baby rolling over onto an arm

The sudden pull causes the radius to slip out of its normal position, trapping soft tissue between the bones of the joint.

Recognizing the Signs and Symptoms of Nursemaid’s Elbow

Identifying nursemaid’s elbow early is crucial for prompt treatment. While symptoms can resemble other conditions, there are several characteristic signs to watch for:

What are the typical symptoms of nursemaid’s elbow?

• Immediate pain in the injured arm, elbow, and sometimes wrist or shoulder
• Refusal or inability to move the affected arm
• Holding the arm still and straight at the side
• Slight bend in the elbow with the palm turned toward the body
• Resistance when someone tries to straighten the elbow or turn the palm upward
• Crying or complaining of pain when the arm is moved

Importantly, nursemaid’s elbow usually does not cause visible swelling or bruising. If your child experiences severe pain or you notice swelling, it could indicate a more serious injury, such as a fracture.

Diagnosing Nursemaid’s Elbow: What to Expect at the Doctor’s Office

If you suspect your child has nursemaid’s elbow, it’s essential to seek medical attention. A healthcare professional will need to examine the injury and potentially perform some tests to confirm the diagnosis.

How do doctors diagnose nursemaid’s elbow?

The diagnostic process typically involves:

1. Physical examination: The doctor will check the injured area for swelling, tenderness, and limitations in movement.
2. Medical history: Questions about how the injury occurred and the child’s symptoms will be asked.
3. X-rays: While not always necessary, X-rays may be taken to rule out fractures or other injuries if there’s uncertainty about the diagnosis.

It’s important to note that nursemaid’s elbow cannot be definitively diagnosed through X-rays alone, as the displacement of the radius is often too subtle to be seen on imaging.

Treatment Options for Nursemaid’s Elbow: Reducing the Joint

Once diagnosed, the treatment for nursemaid’s elbow is relatively straightforward and often provides immediate relief.

How is nursemaid’s elbow treated?

The primary treatment for nursemaid’s elbow is a procedure called “reduction,” which involves:

1. The doctor gently manipulating the arm to release the trapped tissue
2. Moving and twisting the arm to allow the radius to slip back into its normal position
3. A characteristic “pop” or “click” may be felt or heard as the joint returns to place

After a successful reduction, most children experience immediate relief and can use their arm normally within a few minutes. In some cases, additional care may be recommended:

• A sling for comfort for 2-3 days, especially if treatment was delayed
• A hard splint or cast for 1-2 weeks if the injury occurred several days prior

If pain persists after reduction, it may indicate a fracture that wasn’t apparent initially. In such cases, follow-up X-rays and further treatment may be necessary.

Preventing Nursemaid’s Elbow: Tips for Parents and Caregivers

While accidents can happen, there are steps parents and caregivers can take to reduce the risk of nursemaid’s elbow.

How can nursemaid’s elbow be prevented?

To help prevent nursemaid’s elbow:

• Avoid pulling or lifting children by their hands or wrists
• Don’t swing children by their arms
• Lift children by grasping their body under the arms
• Teach older siblings and other caregivers proper lifting techniques
• Be cautious when helping children down from high surfaces

By being mindful of how you handle and play with young children, you can significantly reduce the risk of this painful injury.

Long-Term Outlook and Recurrence of Nursemaid’s Elbow

While nursemaid’s elbow can be a frightening experience for both children and parents, it’s important to understand the long-term implications and potential for recurrence.

Can nursemaid’s elbow happen again?

Unfortunately, once a child has experienced nursemaid’s elbow, they may be more susceptible to recurrence. This is because the ligaments that hold the radius in place may be stretched or weakened after the initial injury. However, the risk of recurrence typically decreases as the child grows older and their ligaments become stronger.

To minimize the risk of recurrence:

• Continue to follow prevention guidelines
• Be extra cautious when handling the previously affected arm
• Inform other caregivers about the child’s history of nursemaid’s elbow
• Consider teaching older children how to protect their own arms during play

What is the long-term prognosis for children who experience nursemaid’s elbow?

The good news is that nursemaid’s elbow, when properly treated, does not typically cause long-term complications or permanent damage. Most children recover fully and quickly after the joint is reduced. However, it’s essential to:

1. Follow up with your pediatrician as recommended
2. Monitor the child for any persistent pain or limited mobility
3. Seek medical attention if symptoms recur or worsen

With proper care and prevention, most children outgrow the risk of nursemaid’s elbow as their joints and ligaments mature.

When to Seek Emergency Care for Elbow Injuries in Children

While nursemaid’s elbow is generally not a medical emergency, there are situations where immediate medical attention is necessary for arm or elbow injuries in children.

What signs indicate a more serious elbow injury?

Seek emergency care if your child experiences:

• Visible deformity of the elbow or arm
• Severe swelling or bruising
• Intense pain that doesn’t subside
• Numbness or tingling in the hand or fingers
• Inability to move the fingers or hand
• Signs of circulatory problems, such as pale or bluish skin

These symptoms may indicate a fracture, complete dislocation, or other serious injury that requires immediate medical intervention. In such cases, it’s crucial not to attempt to manipulate or reduce the joint at home, as this could cause further damage.

How can parents differentiate between nursemaid’s elbow and more serious injuries?

While it can be challenging for parents to distinguish between nursemaid’s elbow and other injuries, there are some key differences to consider:

1. Nursemaid’s elbow typically doesn’t cause visible swelling or bruising
2. The pain in nursemaid’s elbow is usually less severe than in fractures
3. Children with nursemaid’s elbow can often move their fingers and hand normally
4. The mechanism of injury in nursemaid’s elbow is usually a pulling or tugging motion, rather than a direct impact

When in doubt, it’s always best to err on the side of caution and seek professional medical evaluation. A healthcare provider can perform the necessary examinations and tests to determine the nature of the injury and provide appropriate treatment.

Emotional Support and Reassurance for Children with Nursemaid’s Elbow

Experiencing nursemaid’s elbow can be distressing for young children. As a parent or caregiver, providing emotional support is crucial throughout the diagnosis and treatment process.

How can parents comfort a child with nursemaid’s elbow?

To help your child cope with the experience:

• Remain calm and reassuring, as your child will take cues from your behavior
• Explain the situation in simple, age-appropriate terms
• Offer comfort and distraction during the medical examination and treatment
• Praise your child for their bravery during the reduction procedure
• Provide extra attention and care during the recovery period

Remember that while the physical discomfort of nursemaid’s elbow is usually short-lived, the emotional impact can linger. Be patient and understanding if your child seems more clingy or anxious about arm movements in the days following the incident.

Should parents discuss the incident with older children to prevent future occurrences?

For older children who have experienced nursemaid’s elbow, having a conversation about the incident can be beneficial:

1. Explain what happened in terms they can understand
2. Teach them to be aware of situations that might put stress on their elbows
3. Encourage them to speak up if someone is handling their arms roughly
4. Discuss safe ways to play and interact with younger siblings or friends

By involving children in their own safety, you can empower them to take an active role in preventing future injuries while also alleviating any lingering fears or concerns they may have about the experience.

Nursemaid’s Elbow – HealthyChildren.org

A pulled elbow (also known as nurse­maid’s elbow) is a common, painful injury generally among children under four years old but occasionally older.

Nursmaid’s elbow occurs when the tissue of the outer part of the elbow slips between the bones of the joint. This happens be­cause the child’s elbow joint is loose enough to separate slightly when their arm is pulled to full length (while being lifted, yanked, or swung by the hand or wrist, or if they fall on their outstretched arm). The nearby tissue slides into the space created by the stretching and becomes trapped after the joint returns to its normal position.

A nursemaid’s elbow injury usually doesn’t cause swelling, but the child will complain that the elbow hurts, or cry when their arm is moved. A child will typically hold his arm close to the side, with the elbow slightly bent and the palm turned toward the body. If someone tries to straighten the elbow or turn the palm upward, the child will resist because of the pain.

Treating nursemaid’s elbow

This injury should be treated by a pediatrician or other trained healthcare provider. Since elbow pain can also be due to a fracture, your pediatrician may need to consider this before the elbow is “reduced” or put back into place.

Your doctor will check the injured area for swelling and tenderness and any limitation of motion. If an injury other than nursemaid’s elbow is sus­pected, X-rays may be taken. If no fracture is noted, the doctor will move and twist and flex the arm gently to release the trapped tissue and allow the elbow to return to its normal posi­tion.

Once the doctor has moved the elbow back in place, the child will generally feel immediate relief and within a few minutes should be using their arm nor­mally without any discomfort. Occa­sionally, the doctor may recommend a sling for comfort for two or three days, particularly if several hours have passed before the injury is treated suc­cessfully.

If the injury occurred sev­eral days earlier, a hard splint or cast may be used to protect the joint for one to two weeks. Persisting pain after a reduction may mean that a fracture occurred that may not have been ap­parent at the time of initial X-rays.

Prevention

Nursemaid’s elbow can be prevented by not pulling or lifting your child by the hands or wrists, or swinging her by the arms. Instead, lift your child by grasping her body under the arms.

Last Updated

6/2/2021

Source

Caring for Your Baby and Young Child: Birth to Age 5 7th Edition (Copyright © 2019 American Academy of Pediatrics)

The information contained on this Web site should not be used as a substitute for the medical care and advice of your pediatrician. There may be variations in treatment that your pediatrician may recommend based on individual facts and circumstances.

Nursemaids Elbow | Boston Children’s Hospital

The elbow joint is made up of three bones: the humerus, the ulna, and the radius. A nursemaid’s elbow, or “pulled elbow,” occurs when the ligament that holds the radius in place at the elbow joint slips and the end of the radius shifts out of position. As a result, the elbow becomes partially dislocated.

The term “nursemaid’s elbow” goes back to the days when nursemaids took care of children and were blamed for causing the injury by tugging on children’s arms. The medical term for nursemaid’s elbow is radial head subluxation.

Nursemaid’s elbow:

• is most common in toddlers and preschoolers between 2 to 5 years old, when the ligaments are still immature
• is rare in children older than 6 years whose bones are typically stronger and more mature
• is temporary and does not cause permanent damage

What are the symptoms of nursemaid’s elbow?

Symptoms of nursemaids elbow often resemble other conditions or medical problems, therefore, it’s important to bring your child to their doctor for a diagnosis.

Symptoms may include:

• immediate pain in the injured arm and elbow, and sometimes pain in the wrist and/or shoulder
• refusal or inability to move the injured arm
• holding arm still and straight at their side, possibly with the elbow slightly bent and the hand turned toward the body

Nursemaid’s elbow can be painful, but there is usually no bruising or swelling. If your child is in severe pain, they may have a fracture.

What causes nursemaid’s elbow?

Nursemaid’s elbow can be caused by tugging on a child’s arm to stop a fall, make them walk faster, or lifting or swinging them by the arms. It can also occur when a toddler falls onto outstretched arms or when a baby rolls over onto an arm.

How is nursemaid’s elbow diagnosed?

Your child’s doctor will perform a physical exam of your child’s arm, looking for places where the arm may be tender (particularly around the elbow). If there’s a possibility your child has a fracture, their doctor will order an x-ray.

How is nursemaid’s elbow treated?

To treat nursemaid’s elbow, your child’s doctor or another clinician will move the radius back into its correct position, a procedure called a reduction of the elbow.

There are a few ways to do a reduction for nursemaid’s elbow. Most commonly, the clinician will hold your child’s wrist and elbow, and then turn the arm and bend the elbow to gently move the radius. When the bone goes back in place, you may hear a “click” as the ligament moves back to cover the radius. This only takes a few seconds, but it can be briefly painful for your child. Sometimes, it takes more than one try to reduce a nursemaid’s elbow.

Once the elbow is back in place, children are usually much more comfortable. Your child’s doctor may have you sit with your child for a few minutes after the reduction. After 15 minutes or so, your child should be able to start moving their arm. When this happens, no other treatment is needed.

If your child has a fracture, their arm will be placed in a cast while the bones heal. Even if do not have fracture, if your child does not move their arm, their doctor may put their arm in a cast for one to two weeks. This will give their elbow joint a chance to rest and allow any swelling to go down. Sometimes a cast also helps the radius settle into a better position.

What is the long-term outlook for nursemaid’s elbow?

A nursemaid’s elbow can usually be taken care of by your child’s pediatrician. If your child begins using their arm normally again, they probably do not need to follow up with an orthopedic specialist. If your child continues to be in pain or refuses to use the arm, schedule a follow-up appointment.

To avoid nursemaid’s elbow from happening in the future, avoid pulling on your child’s arms, and do not pick up or swing them by the arms. Most children outgrow the tendency for nursemaid’s elbow by the age of 6.

How we care for nursemaid’s elbow at Boston Children’s Hospital

Every year the Orthopedic Center at Boston Children’s Hospital treats thousands of children, adolescents, and young adults with injuries of all complexities. Thanks to our pediatric expertise, we can precisely diagnose conditions related to the growing musculoskeletal system and create optimal care plans.

At our Orthopedic Urgent Care Clinics, we care for injuries that require prompt medical attention but are not serious enough to need emergency room care. We offer urgent care services in four locations: Boston, Waltham, Peabody, and Weymouth.

Elbow pain – causes and treatment of pain in the elbow joint

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Elbow pain is a complex condition that can develop for various reasons. Elbow pain can occur on both the right and left arm and is a fairly common problem. Its appearance does not depend on age, but is often associated with trauma or features of professional activity. The elbow joint experiences a significant daily load, which can lead to pain when bending and extending the arm, as well as when lifting and carrying heavy loads.

Medical tests are required for a correct diagnosis.

Contents of the article:

• Structure of the elbow joint
• Causes of pain
• Classification of pain sensations
• Diagnostics
• Treatment
• Prevention

Structure of the elbow joint

Elbow the joint is the connection of three bones: the ulna, radius and radial head . It provides movement of the arm in the flexion and extension direction, as well as rotational movement. The elbow joint contains an articular cavity, which is filled with synovial fluid and surrounded by a capsule of ligaments. Inside the capsule are the cartilaginous surfaces of the bones, which provide smooth sliding and cushioning during movement. Also in the joint are muscles and tendons that connect the articular elements and ensure their functional work. Timely treatment of injuries and diseases of the elbow joint will help maintain its health and full functionality.

Causes of pain

Basically, the cause of pain in the elbow is microtrauma and tissue deformities, infectious and purulent diseases, swelling, complications after trauma to the shoulder or knee joint, deformity of the spine and hip joint.
Pain can appear in both the left and right elbow, and its causes can be completely different. To begin the treatment of this condition, you need to study them in more detail. Some of the more common causes include:

• Injuries that may be caused by improper flexion or extension of the arm, excessive load or carrying heavy bags.
• Circulatory disorder caused by constriction of blood vessels, both small and large.
• Age-related cartilage changes or tissue wear caused by inflammatory processes in the synovial bag.
• Epicondylitis is an inflammation of the ligaments of the elbow joint, which is one of the most common causes. This disease causes pain after exercising, carrying heavy objects, or rotating the arm for long periods of time. At rest, discomfort does not appear.
• Cervical osteochondrosis, which can cause pain not only in the joint, but also spread to the entire arm. This pain may be aggravated by hypothermia, and may also be accompanied by numbness of the arm.
• Osteoarthritis, characterized not only by pain, but also by a crunch during flexion or extension of the elbow joint. If treatment has not been prescribed, the joint may deform and change its appearance.
• Arthritis, which is usually systemic and is accompanied not only by pain, but also by redness and swelling of the joint.
• Bursitis is a disease of the synovial sac.
• Tendinitis is an inflammation of the tendons.
• Diffuse fasciitis – inflammation of the muscles.
• Synovial chondromatosis.
• Herniation or protrusion of the intervertebral disc.

Certain cardiovascular or neurogenic conditions may also cause elbow pain, including:

• Inflammatory diseases of the nerve roots that may result from injury to the joint.
• Cubital tunnel syndrome, which is caused by a genetic predisposition or congenital anatomy disorder of the elbow.
• Myocardial infarction, which can cause joint pain and numbness.
• Oncological and systemic diseases.
• Injuries such as sprains, fractures or bruises can also cause pain in this area. Sometimes pain in the elbow joint can be associated with damage to the internal organs, so you need to pay attention to any abnormalities in the joint.

Classification of pain sensations

There are several ways to determine the cause of discomfort in the elbow joint, depending on the location of the pain and the time of its occurrence: . This type of pain can also cause medial epicondylitis and tendon rupture.

If discomfort occurs while shaking hands, this may indicate a serious injury to the elbow joint.

There is a classification of pain sensations in the elbow joint depending on their nature:

• Referred pain occurs due to damage to internal organs or other parts of the body, not accompanied by external changes in the elbow.
• Projected pain is due to trauma or compression of the spinal canal.
• Neuropathic pain can be very severe, accompanied by burning and tingling.
• Sharp pains are typical of serious injuries of the elbow joint, such as fractures, sprains and torn ligaments. Acute pain can also accompany reactive and rheumatoid arthritis, as well as bursitis.
• Burning pains can be caused by nerve inflammation or gout.
• Aching and dull. Osteoarthritis, and even malignancy, provokes such sensations.
• Abrupt (provoked by trauma).
• Permanent. They appear due to the development of serious diseases of the supporting system.

Which doctor should I contact?

Consultation with a specialist is a mandatory first step in any diagnosis. To get a consultation, you need to make an appointment with a rheumatologist, osteopath or orthopedic traumatologist and tell about all the problems and symptoms you have. If any examinations have been performed previously, the results should be provided to the doctor.

After a visual examination and palpation, the specialist directs the patient for testing. Particular attention is paid to the appearance of the integument, the mobility of the joints and their shape. It is also important to note the presence of pain when bending the elbow.

For a complete study of the disease, the doctor needs to learn about the patient’s professional activities, possible stress and recent injuries. In addition, it is important to find out exactly when the person felt discomfort and pain, and what he did at that time.

Diagnosis

Various methods and procedures are used to diagnose the causes of pain in the elbow joint, among which:

• A doctor-patient interview to find out the location of pain, its nature and factors that can cause it.
• Visual inspection and palpation of the affected area to detect possible changes in the structure of the joint.
• X-ray, which is ordered if an injury or degenerative disease is suspected.
• Neurological tests to check the function of the nervous system.
• CT or MRI may be recommended if malignancy or osteochondrosis is suspected.
• Complete blood count, which can reveal the presence of an inflammatory process in the body.
• An ECG to be done if the pain in the elbow is burning.
• Ultrasound of the elbow.
• Specific tests and rheumatic test.
• Arthroscopy, which may be ordered to examine the condition of the joint in more detail.

A comprehensive examination of the elbow joint helps to determine the causes of pain and develop the most effective treatment plan, depending on the identified pathologies and the condition of the joint.

Treatment

Anti-inflammatory drugs, physiotherapy, injections, intra-articular complexes and electrophoresis can be used in the treatment of elbow pain. Depending on the stage of the disease, rehabilitation can take from several days to several years.

If is injured, the arm should be immobilized with a splint or bandage, and cold should be applied to the joint to reduce swelling and bleeding. If the victim is in intense pain, then an anesthetic is given, but no attempts should be made to reduce or move the elbow joint so as not to worsen the injury.

For pain that is not related to injury, rest the arm. If there are no signs of acute inflammation, then painkillers and warming agents can be used. If there is a rapid increase in swelling, redness of the joint, intense pain, weakness or fever, you should consult a doctor as soon as possible.

Conservative treatment includes reduction or reposition for dislocations and displaced fractures. Patients at the stage of outpatient or inpatient treatment are recommended a regimen that helps to minimize the manifestations of the pathological process and promotes recovery. The mode is selected individually and may include fixation with a plaster splint, suspension of the limb on a scarf bandage, the use of orthopedic devices and correction of motor activity.

Drug therapy for may include oral NSAIDs and chondroprotectors, as well as topical agents. According to indications, chondroprotectors and glucocorticoids can be introduced into the joint. The elbow joint belongs to the “capricious” joints and does not always respond positively to physiotherapeutic methods of treatment, therefore, such procedures are carried out with caution and only if there are sufficient indications. During the recovery period, massage and physiotherapy exercises can be used.

Interventions associated with elbow surgery can be performed using classical open access or minimally invasive arthroscopic techniques. Depending on the nature of the pathological process, several groups of operations can be distinguished.

The first group of interventions is associated with traumatic injuries: osteosynthesis of the condyles of the shoulder and olecranon, resection of the head of the beam, open reduction of dislocation of the bones of the forearm or head of the beam.

The second group is associated with degenerative pathologies: removal of loose bodies, chondroplasty and arthroplasty are performed.

The third group of operations is associated with tumors: excision of neoplasia, segmental or marginal resection, amputation of the shoulder.

For contractures and ankylosis, considering soft tissue or hard structures, redressing, arthrolysis, arthroplasty or arthrodesis is performed. In some cases, the joint may be replaced with an artificial implant during arthroplasty.

Preventive measures

Proper exercise can help you lose weight, strengthen your muscles and improve blood circulation in your body. However, too much load, sudden movements and heavy lifting can lead to injury and the development of chronic diseases.

Changing your diet can also have a positive impact on your health. Eliminate high-fat foods and add more fish, fruits, and vegetables to your diet. Gelatin can be beneficial for bone health, and drinking enough water is essential for the body to function properly.

Quitting alcohol can also have a positive effect on health. Some vitamins, especially calcium, can be included in the diet to support bone health.

It is important to protect your joints from hypothermia during the cold season, providing them with reliable protection from the cold. In addition, stress and lack of sleep can have a negative impact on health, so it is important to improve sleep patterns and avoid stressful situations.

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Zhilina Anzhela Lvovna

Osteopath, pediatric neurologist, doctor of the first category

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Dmitry Alekseevich Somov

Osteopath

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Muschak
Vladimir Ilyich

9000 4 Osteopath

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Petrov Vladimir Konstantinovich

Osteopath, pediatrician, pediatric surgeon

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By submitting an application, you agree to the Terms and Conditions children from one to five, or Why a child should not be pulled by the hand

The usual picture: an adult leads a small child by the hand and pulls him with force when he does not obey or is naughty. Well, it is quite possible that the child’s elbow joint was injured at that moment. How it happens and why you can’t pull children by the hand, says Daria Pavlova, an orthopedic traumatologist at the Rassvet clinic.

– It seems that preschool children are very fragile and any wrong touch can harm them.

— Every child has a strength limit. Of course, you don’t have to throw them up, throw them somewhere, and at any age. But here it’s more about the specifics of injuries — they are different for each age category.

— What injuries do you most often deal with in preschool children?

– The most common injury in children from one to five years old is subluxation (that is, incomplete dislocation). Fractures of all kinds often occur. But their cause is not necessarily the negligence of parents, often it is simply a matter of a combination of circumstances that cannot be prevented. After all, you can’t forbid children to run or ride a bike.

– “Nanny’s Elbow Syndrome” is it just a subluxation?

– Yes, “nanny’s elbow” is a subluxation of the radius. The elbow joint has a very complex anatomy, it consists of three bones: the humerus, ulna and radius. They are connected to each other by a ligamentous apparatus and a joint capsule. One of these ligaments (annular) may become pinched as a result of subluxation of the head of the radius. That is, it is not damaged, does not tear, does not shift radically in any direction, but is pinched. In an adult, for example, as a rule, the ligament is not so plastic, so it simply breaks. And in small children, it overstretches and slips a little from its place. Therefore, this is not a dislocation, but a subluxation, and it occurs only at such a young age.

Illustration: Pepermpron / Shutterstock / Fotodom

— Why is this happening?

— The name “nanny’s elbow syndrome” explains a lot: as a rule, an injury occurs due to a twitching effect on the child’s arm. Subluxation occurs, for example, when we see that the child is running somewhere in the wrong direction, and we pull him by the wrist. Or we sharply pull on the forearm so that it does not fall. This injury always occurs due to a sharp extension of the arm. Another option is when the child is taken by the hands or forearms and spun like a carousel.

— How to understand that a child has received such an injury? What complaints to pay attention to?

– There is a fairly characteristic clinical picture. After a sharp impact on the hand, you can hear or feel a click. It does not always happen, but in half of the cases – for sure. After that, the child may scream or cry. Also, situations when a child begins to take care of his hand, does not bend it completely, keeps it straight, and does not allow him to touch it, can also indicate the “nanny’s elbow syndrome”. But, unlike a fracture, “nanny’s elbow” will not be accompanied by swelling or bruising. Therefore, many parents may decide that nothing happened.

– They write on the Internet that “it’s easy to adjust the arm yourself.” This is true?

— No. Of course, the reduction of a subluxation is a simple and quite short-term manipulation that does not require either painkillers or radiographs. But it is very important that this is done by a person who knows how to do everything right. Even young traumatologists do not always manage to make the annular ligament fall into place the first time – as a rule, this happens in cases when parents go to the emergency room not immediately, but several days after the injury. I do not recommend doing this procedure on your own.

– Can such a subluxation have unpleasant consequences?

– If the parents asked for help in a timely manner and there were no problems with the reduction of the annular ligament, then recovery occurs quite quickly and no problems arise. No plaster is applied to the arm, it is not fixed by anything. It is only recommended to exclude active games for the first time, to provide the hand with a gentle regimen. By the way, another reason to go to the emergency room is a qualified examination of the child. Sometimes fractures occur without significant displacement, and it is for their identification that additional examination may be required. And then gypsum.

Photo: Sergey Novikov / Shutterstock / Fotodom

— How long does rehabilitation take?

– The main recovery takes place in the office of a traumatologist, and then 2-3 weeks – and you can return to your usual life without any restrictions.

– So that history does not repeat itself, the child should no longer be raised by the arms?

— It is best to lift the child by the body or armpits. If you are leading a child by the hand – hold him by the elbow or shoulder, in winter – by the hood.

– Speaking of shoulders. Sometimes parents take small children by the shoulders and start shaking them to stop the tantrum.

– Don’t shake the children, it really can harm them. If there are problems associated with the manifestation of emotions, it is better to contact a neurologist, a psychologist.