Nursemaids Elbow

Description: Nursemaid's elbow: Pulling out the diagnosis Source: Contemporary Pediatrics Originally published: June 1, 2000
By Nicholas A. Waanders, MD, PhD, Elizabeth Hellerstein, MD, and R. Tracy Ballock, MD
Pulled elbow is easily reduced. First, however, you must be sure that the injury is not something more serious, like a fracture. Elbow injuries, ranging from simple contusions to complex fractures, are very common in children. Children younger than 5 years often experience "pulled elbow." This injury, which is frequently called "nursemaid's elbow," also is termed "radial head subluxation." In pathoanatomical terms, it is an acute annular ligament interposition into the radiocapitellar joint.1 The injury occurs when someone pulls the young child's forearm, drawing apart the elbow joint and tearing the margin of the annular ligament attachment, the edge of the ligament that attaches the ligament to the bone. This tear allows the annular ligament to become trapped in the radiocapitellar joint. A simple reduction maneuver releases the ligament from the joint, often dramatically resolving symptoms.