Pulled Elbow In Children

What is a pulled elbow?

A pulled elbow is an injury that occurs when one of the elbow bones slips out of its normal place. It is also called a nursemaid's elbow. The bones of the elbow are held together and supported by ligaments. In children, these ligaments may still be weak. A forceful stretching of the elbow causes the radius to slip out of the ligament that supports it. This causes the ligament to slide over the tip of the bone and get trapped inside the joint. A pulled elbow is the most common injury of the upper limb in children under 6 years old.

What causes a pulled elbow?

A sudden pull of your child's arm may cause a pulled elbow. A pulled elbow commonly occurs when your child's arm is outstretched and turned inward. A pulled elbow may be caused by any of the following:

  • Dragging your child by the hand

  • Grabbing your child's arm to keep him from falling

  • Lifting your child by the hand, wrist, or forearm

  • Swinging your child by the hands or forearms

What are the signs and symptoms of a pulled elbow?

Your child will have pain in the injured elbow and may cry right after his arm was pulled. The arm is usually kept slightly bent with the forearm facing down. Your child may have a hard time moving his elbow or arm, or may refuse to use it. The elbow may look normal, without swelling or deformity.

How is a pulled elbow diagnosed?

Your child's caregiver will ask questions about your child's symptoms. He will ask how the elbow got injured and how long the injury has been present. Your child's caregiver will carefully check your child's arm from the wrist up to the shoulder. He will check for signs of broken bones, open wound, or other problems. Hey may examine both the injured and normal elbow.

How is a pulled elbow treated?

Your child's caregiver will release the trapped ligament and return the bone to its normal position. He will move your child's arm in different directions. A click may be heard or felt once the bone returns to its place. If treatment fails or was delayed for more than 12 hours, your child may need to wear a splint. A sling may be needed if your child's pulled elbow happens again.

When should I contact my child's caregiver?

  • Your child refuses to move his arm again.

  • Your child's pain does not go away or comes back.

  • You have questions or concerns about your child's condition or care.

When should I seek immediate care or call 911?

  • Your child has increased pain on the affected elbow.

  • Your child gets another pulled elbow.

  • Your child's arm or hand feels numb and tingly.

  • Your child's skin or fingernails become swollen, cold, or turn white or blue.

Care Agreement

You have the right to help plan your child's care. Learn about your child's health condition and how it may be treated. Discuss treatment options with your child's caregivers to decide what care you want for your child. The above information is an educational aid only. It is not intended as medical advice for individual conditions or treatments. Talk to your doctor, nurse or pharmacist before following any medical regimen to see if it is safe and effective for you.

© 2014 Truven Health Analytics Inc. Information is for End User's use only and may not be sold, redistributed or otherwise used for commercial purposes. All illustrations and images included in CareNotes® are the copyrighted property of A.D.A.M., Inc. or Truven Health Analytics.

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