Pulled elbow

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This overview of pulled elbow, or subluxation of the radial head, covers signs, causes, treatment and how to help your child.

Key points

Pulled elbows are caused by a sudden pull or jerk to the arm.
They are most common in younger children.
They are usually easily diagnosed and fixed by a health-care provider.
Avoid sudden pulls or jerks to your child's arm.

Introduction

What is a pulled elbow?

Pulled elbow occurs when one of the forearm bones (the radius) slips through a ligament at the elbow. A ligament holds the bones in place. When a child's arm is pulled, twisted or jerked, this causes the ligament to stretch and the radius to slip out of place.

It is also called nursemaid's elbow or subluxation of the radial head.

Pulled elbow is common in young children. It normally occurs between the ages of six months and five years.

Radius, ulna and ligament in normal elbow, and partially slipped radius and torn ligament in pulled elbow — Pulled elbow occurs when one of the forearm bones (the radius) slips through a ligament at the elbow. When a child's arm is pulled, twisted or jerked, this causes the ligament to stretch and the radius to slip out of place. This can also happen during certain play activities, such as swinging from monkey bars or even lifting or swinging your child by the arms.

Signs and symptoms

Signs and symptoms of a pulled elbow

After a sudden pull or twist to the arm, the child will usually cry out in pain.

Your child may hold their arm hanging limply at their side. They may not use their arm at all.

It is normal for your child to feel upset. They may cry or complain only if the arm is moved. It is also possible that they do not cry and are not upset. Many children will point to the wrist when asked where it hurts, even though the problem is in the area of the elbow.

Treatment

Treatment in hospital

Your child will not usually need an X-ray. The health-care provider will move the arm and slip the bone and ligament back into place. This causes some pain for the child, but it is usually a very quick procedure that lasts seconds.

Your child will usually start to use their arm within 15 minutes after this procedure. They may be hesitant at first. If the injury has been present for many hours, it may take a bit longer for them to use their arm normally.

Prevention

Preventing a pulled elbow

Avoid sudden pulling or jerking of your child's arm, such as lifting or swinging your child by the hands or wrists. Tell other family members as well. Some young children are particularly prone to pulled elbows. They usually grow out of it by five or six years of age.

Helping your child

Taking care of your child at home

A pulled elbow will not cause long-term problems for your child. Once the elbow is back into its normal position, your child will start to use it normally again. You do not need to restrict your child's activity.

Your child may have some pain after the procedure. If so, give a mild pain relief medication such as acetaminophen or ibuprofen.

When to seek medical attention

Speak to your child's health-care provider if:

your child is still not using their arm normally by the next day after the procedure
your child seems to be in a lot of pain
this type of injury happens again

Last updated: April 2nd 2024