16 answers

Nursemaid Elbow

My 22 month old daughter was diagnosised with Nursemaid Elbow. She was seen in the ER and the doctor set her elbow... three times. Since she still refused to move her arm while in the ER, he did take an x-ray. According to the doctor most children begin using their arm again after about 15 - 30 minutes after the adjustment is made. The x-ray showed no fracture and all the bones were aligned properly. Her shoulder and hand were also examined by the doctor and appeared fine. So they sent us home. We were told to give her Motrin every six hours. Yet, almost two days later she still refuses to move her arm. She can bend her arm at the elbow and straighten her arm but that's it. I've called the doctor (twice) but they believe she is just favoring it since it's sore. But I'm worried that maybe the elbow might not be set properly or it popped out of socket again. Has anyone had a child with nursemaid elbow and how long did it take for them to use their arm again?

What can I do next?

So What Happened?™

Thanks everyone. We followed up with our pediatrician - who then referred us to a orthopedic at Children's. We saw the orthopedic and he said that our daughter's elbow was not reduced (set) properly in the ER. He reduced (set) her elbow and in about 10 minutes she was fine. She was using her arm and acting as if nothing happened. He did show us how to reduce it ourselves if it should happen again. He did say that the elbow would have reduced itself even if we didn't bring her in again - but that could have taken another week or so. But we are so glad we didn't wait - we are all happier now that she is back to 'normal'. Thanks again!

Featured Answers

Trust me, if it wasn't set properly should would be crying all the time an unable to use it at all. Try watching her play, when she doesn't know you are there. She could be doing it for attention, especially because you are stressed out about it. Good luck.

call pediatrician just in case

Honestly my son had it and 2 x popped it back in and 30 min later was fine.

More Answers

My youngest son had it when he was a baby too. I would agree that it sounds strange that she still isn't using it. Every time it happened to him, he would be fine the MINUTE it was reset. Not sure what's going on with your child, but it doesn't sound right.

1 mom found this helpful

Hello K.,

My 3-year-old daughter has had nursemaid's 3x in last year. Within seconds of it being popped back in place, she can use it. She has never complained that it still hurt afterward. Never! I think something else is going on. I personally would take her to a pediatric orthopedic doctor. Good luck to you!

hi- my daughter had nurse maid's elbow...she too would favor the arm at first. If you can gently bend her elbow to show her that it does not hurt and and that it doesn't just "happen" by using the arm in a regular fashion, she might begin to trust it more. If there is a lot of pain, id get another opinion. I know my daughter was terrified it would keep happening. It did happen a few times but just as the dr told us, it dissapeared when she turned 4.
Unfortunately, once this happens, she is susceptible to this until she is about 4. Just be careful when dancing with her, swinging her around (even when she begs daddy to do it!
Holding that hand when crossing the street ( if she pulls ahead, as you know it it's a chioce between the elbow and a safety issue, you know what you are going to do.

Also, I was taught by my family doctor how to reset the arm- saved many trips to the we, the amount of pain for baby, and of course, money. The first time is scarey, because you know you have to do it and don't want to cause pain- but it is not difficult and we skipped countless trips to the ER

My daughter had Nursemaid's elbow when she was 21 months old. Hers actually reset itself immediately after the injury (so said the ER MD). But even so, it was very tender for her for almost two days after the injury. She would favor that arm and was very hesitant to use it.

But, eventually, I would see her using it more and more. Sometimes I would hand her things just to see which arm she would use. A sort of test without her knowing I was paying attention to her arms.

The way you described it, your daughter has full mobility of her elbow joint but isn't using her shoulder. Does she lock her shoulder up? Might she be having pain there instead? Does she have full use of her fingers? Check her grip, can she hold tightly to things?

call pediatrician just in case

Honestly my son had it and 2 x popped it back in and 30 min later was fine.

My oldest daughter had this when she was around 3. It all started when she took a tumble off the kitchen chair, and landed on her arm. I picked her up, thinking she was just crying because she fell, and as soon as I saw her arm, I knew it was worse. We ended up at the ER and her in surgery the next morning for a greenstick fracture of both the bones in her forearm. Fast forward a couple months, she took a tumble off of a kid-sized couch, literally 3 inches, and was screaming about her arm. I'm thinking, AGAIN?? REALLY?? Off we rushed to the ER and turns out that during all the xrays, her elbow got popped back into place...but she was diagnosed with nursemaids elbow. She was "fine" right after, just a little crying because she was scared and probably a little sore.

It may be your little one is just sore, but I think it is worth getting checked out again. During our whole ordeal, the ER doc or her orthopaedic doc (I can't remember which one) did mention that sometimes fractures, especially in little kids, don't show up on film right away. It can take a couple days for a break or stress line to show on an xray. I would take her back to the doctor or to the ER and have them take xrays again and see if anything new shows up.

Good luck to you!

My son had it at about the same age, and he was immediately using it again. I would have it checked out.

In my experience with Nursemaids Elbow, there are not really any symptoms after the problem is fixed. I have 2 kids who have gotten nursemaids elbow soooo many times, I can't even count. My husband and I know how to fix it, usually my kids are fine in a few minutes...they are just nervous about feeling pain again.

That's just speaking for my kids, so maybe your daughter is different or maybe it could be something more. GOod luck!

this has happened to my daughter about 8 times now. She is about to turn 3 in a few months, and I'm sure it will happen a few more times before she reaches that magic age of 5.

Asyou can see by the comments, MOST of the time, the childe begins to use the arm with 15-30 minutes of being fixed. With my daughter it is immediately, probably b/c it happens to often to her, she now knows that it's "all better" once we pop it back in. But, the exception is that it may take the child MUCH longer to trust that they can use the arm again.

It might help to move her arm for her, and if she doesn't respond in pain, she might be scared that it will hurt, then I would just let her go. Showing her that she can move her arm without it hurting might help or it might not. Children can be sensitive and stubborn and we all have our own personalities. But I would say, as long as there are absolutely no signs of pain, just give her extra time to get over it.

AND I would invest in learning how to reset it as well. We've even had to teach our sitter how to do it b/c she got it twice while I was at work. Although, mnost of the time it happens b/c she has 4 older brothers and acts like a boy with them herself. There's nothing to stop your heart like seeing your toddler rolling around in a pile of 6-16 year old boys.

Hey K.,

My daughter has the same thing happen. The doctor showed my husband and I how to set it or pop it back in properly when it happens. She is also fine within minutes of it going back in. I have never had to give her Tylenol or Motrin for it either. It has happened several times. A few times when she is playing with other kids and they grab her arm and tug her along. Your daughter's prolonged favoring sounds weird to me but if she can bend it and move her arm without screaming in pain then maybe something else is wrong with her arm.

Beth

Hi K.,
Our daughter had this problem when she was little, her elbow would pop out and we'd have to take her to the ER to have it reset. the doctor there showed my husband how to set it himself. Our daughter is now 31 and no more problems. Every time Heather popped hers out as soon as it was put back in place she'd used it right away. I to would have it rechecked just to make sure. Children don't know how to explain there pain except to cry. Good luck, I hope you get the answers your looking for.
Sincerely,
J. (Mother of 2 girls -Mom-Mom of 4 wonderful Grandchildren)

When my youngest was 2, the Dr. thought she had nursemaids elbow. She was bending it and moving it and my daughter was screaming horribly, it was so heartbreaking. They ended up doing a x-ray and found out she had a double fracture. Let's just say that I was not happy. The Dr. apologized but really thought it was nursemaid elbow. Maybe they need to look at the x-rays again or maybe she's too scared to move it. Good luck!

Hey K. -

It happened to my son when he was 18mos - We went to the ER twice in one weekend - xrays etc. The docs tried three or more times - then they brought a final dr in that was "real good at popping elbows". With that said - We heard the snap and he immediately was cured - The docs may not be doing it right - ...I would keep calling if I were you. My son had to be monitored until he was five b/c he was so rough and busy - We were taught how to do it too. If they can teach you that would be great so you will know just what to do if it happens again. Good Luck and GOD Bless -

It's amazing how common this unusual thing is! It's happened twice now to my son, most recently just after he turned 4. If you google it, you'll find out that by the age of 5, if not sooner, the bones in the arms should grow into a kind of different shape so that the ligament can't slip of (which is what happens, I think, with Nursemaid's Elbow). Anyway, my son, too, after the excruciating pain of it, was able to use his arm within minutes of having it popped back in. (It's no easy feat, though, to pop them in. The physician/friend who did it the last time says he's only had a 3 in 5 success rate with his own kids.) I can imagine that a less stoic kid than my son, for instance, his sister, who can scream all day after getting a shot, would be reluctant to move her arm for a long time. But you know your child best and should trust your mother's instincts and know that doctors are not infallible. Two days later her arm shouldn't be sore if a Nursemaid's Elbow was popped back in properly.

K.,
It took my daughter almost 3 weeks until she would use it. We even had her in a splint for the second week when she wouldn't use it after the first week. One day she just started to use it like she just realized she had it.
Like you said most cases usually start using them within 30 minutes of reducing them. As an ER nurse I have reduced many at triage (not intentionally) and by the time they were evaluated by the ED doc they were using it without a problem.
Hope this helps.

Trust me, if it wasn't set properly should would be crying all the time an unable to use it at all. Try watching her play, when she doesn't know you are there. She could be doing it for attention, especially because you are stressed out about it. Good luck.

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