Nursemaid's elbow refers to the partial dislocation of the elbow. It commonly affects children less than 6 years of age. The elbow joint consists of 2 bones in the forearm and the humerus bone of the upper arm. When the child's arm is pulled or lifted up suddenly, this displaces the bones. It does not take much effort to dislocate the elbow in children. Since a nanny or nursemaid often cared for many children, this injury became known as the nursemaid's elbow.

Symptoms may include:

• Severe elbow pain, skin tenderness, and elbow slightly bent
• Crying child holding his arm against the abdomen and refusing to use it
• The child is able to move the shoulder without difficulty or pain

WHAT YOUR DOCTOR CAN DO:

• Diagnose the condition by asking about your symptoms, doing a physical exam, and ordering x-rays of the elbow.
• Reduce (manipulate) the injury and return the elbow back into place. A doctor or other trained professional must do this procedure.
• Place the arm in a sling, splint or cast to support the elbow until fully healed.
• Recommend surgery for serious cases involving bone fractures (breaks) or tendon and ligament damage (tendons join muscles to bones and ligaments join bone to bone).

WHAT YOU CAN DO:

Immediately after the injury:

• Support the injured arm with an arm sling or pillow in a position of comfort.
• Apply ice packs to the injured area for 15 to 20 minutes every hour until you see your doctor or go to an emergency room.
• Make sure your child's fingertips and nail beds remain pink. If pale or cold, go to the emergency room immediately.

After treatment or surgery:

• Make sure your child wears the splint, cast or sling as directed by your doctor.
• Keep the injured area elevated above the level of the heart to help decrease swelling.
• Continue ice therapy as directed by your doctor.
• Use acetaminophen (Tylenol) for minor pain and discomfort.

Preventative measures:

• Do not pull, lift or grab children by the arms.
• Teach child care workers about the risks of nursemaid's elbow.
   

WHAT YOU CAN EXPECT:

• Most children who wear the arm sling for a couple of weeks eventually recover completely.
• Delay in treatment can lead to chronic pain, limited movement and damage to nearby tendons, ligaments, nerves, and blood vessels.
• Some children also suffer bone fractures with this dislocation.

CALL 1061 OR SEEK IMMEDIATE MEDICAL ASSISTANCE If your child has symptoms of a nursemaid's elbow injury or if your child still carries the injured arm, or refuses to move the arm at the elbow despite receiving treatment.