Our Summary
This study looked at a common elbow injury in young children known as nursemaid’s elbow, which usually happens when the arm is pulled or yanked. However, the researchers wanted to understand the injury in cases where this pulling or yanking did not occur. They analyzed data from children who had been diagnosed with nursemaid’s elbow but hadn’t experienced the usual cause of the injury.
They found that the children in their study were around 2.4 years old on average. The injury occurred just as often in boys as in girls and could happen to either arm. The most common causes of the injury in this group were falls (57% of cases), direct hits to the elbow (16%), and rolling over (7%). X-rays were used in about half of the cases to diagnose the injury. In 12% of cases, the elbow returned to normal without any medical intervention, and in 87% of the cases, the elbow was successfully fixed on the first try.
The researchers concluded that nursemaid’s elbow can happen in children who haven’t had their arm pulled or yanked. It can be caused by other types of injuries, like falls, hits to the elbow, or rolling over. So, if a toddler has an elbow that they refuse to move and it doesn’t look like it’s broken, it could still be nursemaid’s elbow.
FAQs
- What is the most common mechanism of injury for nursemaid’s elbow in children?
- How often is an x-ray obtained for patients with nursemaid’s elbow?
- Is it possible for nursemaid’s elbow to occur in children without the classic axial traction mechanism?
Doctor’s Tip
Tip: After elbow surgery, follow your doctor’s post-operative instructions carefully, including keeping the elbow immobilized as directed, attending all follow-up appointments, and participating in physical therapy as recommended. This will help ensure a successful recovery and optimal healing of the elbow joint.
Suitable For
Patients who are typically recommended elbow surgery may include those with severe fractures, dislocations, or chronic conditions such as arthritis or tendon injuries that do not respond to conservative treatments. Surgery may also be recommended for patients with persistent pain, instability, or limited range of motion in the elbow joint. Additionally, patients with traumatic injuries or sports-related injuries that result in significant damage to the elbow may also be candidates for surgery.
Timeline
Before elbow surgery:
- Patient experiences a nonaxial traction mechanism leading to nursemaid’s elbow.
- Patient may present with a history of other trauma such as a fall, direct hit to the elbow, or rolling over.
- X-ray may be obtained to confirm the diagnosis.
- Reduction may be spontaneous or attempted on the first visit.
After elbow surgery:
- Patient undergoes surgery to correct the nursemaid’s elbow.
- Post-operative care includes pain management, physical therapy, and follow-up appointments.
- Patient may experience temporary discomfort and limited range of motion.
- With proper rehabilitation, patient can expect to regain full function of the elbow over time.
What to Ask Your Doctor
- What are the potential risks and complications associated with elbow surgery?
- What is the success rate of the specific type of elbow surgery being recommended?
- What is the expected recovery time and rehabilitation process after elbow surgery?
- Are there any alternative treatment options to consider before proceeding with surgery?
- How long will I need to stay in the hospital after the surgery?
- What type of anesthesia will be used during the surgery?
- What kind of post-operative pain management options will be available?
- Will physical therapy be necessary after the surgery, and if so, for how long?
- What restrictions or limitations will I have after the surgery, and for how long?
- What should I do if I experience any complications or concerns after the surgery?
Reference
Authors: Li N, Khoo B, Brown L, Young T. Journal: Pediatr Emerg Care. 2021 Jun 1;37(6):e292-e294. doi: 10.1097/PEC.0000000000001963. PMID: 32149992