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What is pulled elbow? — Pulled elbow is an injury that causes elbow pain. It is a common injury that happens most often in children ages 1 to 4 years. The medical term for pulled elbow is "radial head subluxation." You might also hear it called "nursemaid's elbow."
Pulled elbow can happen when:
●Someone pulls hard on a child's arm by the hand, wrist, or forearm when the child is not expecting it
●Someone grabs a child's arm suddenly, for instance, when the child is about to fall
When this type of movement happens, a ligament can get caught between 2 of the bones in the elbow joint (figure 1). Ligaments are bands of tissue that connect bones together. When the ligament slips between the bones, it causes pain.
Pulled elbow is common in young children. The ligaments in the elbow joint are looser in children younger than 5 years. Because of this, they can get caught between the bones more easily.
What are the symptoms of pulled elbow? — Pulled elbow is painful. When the injury happens, children usually cry and are upset. They usually hold their injured arm straight or slightly bent and close to their body (figure 2). They will avoid using the injured arm.
Should I try to move or straighten the child's arm on my own? — No. Do not try to move the arm. You should bring the child to the doctor or nurse right away.
Will the child need tests? — Probably not. The doctor or nurse should be able to tell if a child has pulled elbow by asking about the injury and doing an exam.
Some children need X-rays. The doctor or nurse will order an X-ray if:
●They think the injury caused a broken bone.
●The procedure to fix the injury (described below) does not work.
How is pulled elbow treated? — Pulled elbow is treated with a procedure to move the ligament and bones back into place. This procedure is very quick. The doctor or nurse usually does this in the office or emergency department.
Children do not usually need pain medicine for the procedure. Although the procedure can hurt, the child will feel much better 5 to 10 minutes after it is done.
After the procedure, the child will probably not need any further treatment.
Can pulled elbow be prevented? — Yes. To prevent this injury, do not pull hard on a child's arm or lift them up by the hand, wrist, or forearm. Instead, to lift the child up, hold them by the upper arms or under the arms.
