Can you make the diagnosis?

Noah’s family is headed to the playground, and Noah is very excited.  Noah, age two, keeps running ahead, and his mom grabs his arm to pull him away from the busy street.

When his mom grabs his arm, Noah screams and holds his elbow.  He continues to complain of pain, and will not move his arm at all.

What does Noah have?

  1.  An elbow fracture
  2.  A nerve injury
  3.  Nothing, he is just being dramatic
  4.  Nursemaid’s elbow

 

If you guessed 4.  Nursemaid’s elbow, you are correct.

Nursemaid elbow is a common elbow injury, especially among children under age 5.  It occurs when a child’s elbow is pulled and one of the bones partially dislocates.

This injury was named during a time when nursemaids (nannies) cared for children and had the reputation of causing this injury by pulling on a child’s outstretched arm.

The bones and ligaments of a young child are soft and still developing. This makes it easy to sustain injuries of this type. Typically, nursemaid elbow is found in children between the ages of 1 to 4, but can be found in slightly older children as well.

This injury can be easily reduced by a physician with the bone put back in place.

nursemaids

While a fracture must be considered, there was no significant trauma that would likely result in a fracture.  A nerve injury would be very unusual without significant trauma.  While two-year-olds can be dramatic, a child who will not move their arm must be thoroughly evaluated.

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