Children might sometimes ask their parents to swing by their arms. While it might seem innocent, it could accidentally cause an injury common among children. Nursemaid’s elbow refers to the partial dislocation of the elbow, also known as the “pulled elbow”. It can happen when someone tries to pull the children’s forearm or hand, especially when the arm is twisted.
The elbow joint is made of the forearm bones (radius and ulna) and upper arm bone (humerus), wrapped around the annular ligament. This ligament is a strong band of fibers that stabilizes the joint during supination and pronation. However, young kids could have looser ligaments, and their connective tissues and joints have not fully developed yet. When kids got pulled on the arms with elbow extension, their radius would move distally, and the annular ligament would slip out of its normal place. It could be quite painful when the annular ligament is stuck between the joints, though there are no swelling, bruising, or other obvious symptoms.
When parents face this sort of emergency, try not to straighten the elbow, and wait till a practitioner performs a “reduction maneuver”, manually pop the elbow back to its place. You may hear a click during the reduction. Children can then move their arms without pain shortly. X-rays are not usually required. But parents should be cautious and check with their doctors if the kids cannot move their arms after the reduction.
Nursemaid’s elbow would not adversely affect bone growth. Ligaments will gradually become stronger when they grow older and rarely dislocate again. To prevent the injury from happening, parents and caregivers should keep in mind not to forcefully pull on the children’s arms. Alternatively, they can hold onto their armpits to pick them up.