Accidents Do Happen: Nursemaid Elbow Injury

My 3-year-old son, Josh, was outside playing in the snow with his Dad and it was becoming darker and colder outside. I remember the wind chill was dropping and my husband knew it was time to come inside. Well, Josh had a different agenda than Dad!  Josh came inside, much against his will, but refused to take off his winter jacket. He proceeded to throw a tantrum as three-year-olds are known to do. My husband tried to explain why to Josh why he needed to take off his wet jacket, but he was not interested in my husband’s rationale.

As my husband attempted to get the jacket off, Josh flung himself back onto the ground and let out a shrill scream. I knew immediately it was not related to his determination to get back outside. I also knew that with his twisting and wiggling, as my husband was trying to remove his jacket, Josh dislocated his elbow. He landed in the Emergency Center with a common injury called “nursemaid elbow”.

As a mom, my first reaction was to get angry with my husband for causing this to happen. However, I quickly realized that my husband did not cause this injury. It was clearly an accident, and accidents do happen.

In fact, nursemaid elbow is a very common injury among babies and young children. It occurs when a child’s arm is twisted and there is a simultaneous pulling to the extended upper arm. Besides pulling an arm through the sleeve of a jacket, examples include lifting the child by the hand, swinging the child while holding the child by the hand, catching a child by the hand to prevent a fall, or pulling a child along when in a hurry.

Signs of a nursemaid elbow include the child: crying with any movement to the injured arm, protecting the injured arm against his body and appearing fine with the exception that he or she will no longer use the injured arm. If you notice your child exhibiting these symptoms, especially after a similar event as listed above, take your child to the emergency center for evaluation and corrective actions.

Treatment for nursemaid elbow, a “reduction,” is a fairly easy fix. In fact, a physician can usually reduce it within seconds. The beauty of this injury is that after reduction, the child is able to immediately return to using his arm as if nothing has happened.

The best advice I can give parents is to avoid suddenly pulling to your child’s hand or forearm. If the injury does occur, keep in mind that it is a very common injury that is quick and easy to treat; so remember there is no point in placing blame on the caregiver who was a part of this event … accidents do happen!

– Linda Reetz, R.N., B.S.N., Director of Emergency Services, Beaumont Hospital, Royal Oak

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