Your child has a pulled elbow. This is not considered a dislocation of the elbow, which is an extremely rare injury in young children.
The radius is one of two bones in the forearm. At the elbow, the radius sits within a ring-shaped ligament. In adults this fits snugly but in children as the radial bone is still growing it can slip out of this ring, injuring the ligament. This can happen from a pulling action on the arm for example, when swinging a small child, lifting them up by their hands or sometimes when a child twists their arm. It commonly occurs in children aged 2-6 years old whilst being grabbed suddenly by the wrist to prevent a child running into the road , or when a child trips or fall whilst their hand is being held.
Following an injury that causes a pulled elbow, children will often cry and not want to move their affected arm because of the pain. They often hold their arm in an unusual position where it is slightly bent at the elbow with the forearm held in front and across their tummy.
The patient’s history of what has happened, the position of the affected forearm and examination make the diagnosis. An x-ray is not usually needed.
Treatment
A pulled elbow is very easily corrected. A nurse or doctor will move your child’s arm in a certain way (manipulation) until a click is often felt as the radius bone pops back under the ligament. This can be briefly uncomfortable for your child but following the treatment most children will feel much better almost straight away and start using the arm as normal soon afterwards.
If the elbow is not successfully corrected with manipulation, the arm is rested in a sling as a spontaneous correction usually occurs within 48 hours. You should give your child regular paracetamol or ibuprofen for any discomfort. The nurse or doctor may give you an appointment to come back to clinic to check your child’s arm is better.
Are there any complications or risks?
Pulled elbows are minor injuries, they heal fast and do not usually occur after six years of age. It is very rare for this condition to result in long term problems.
How to prevent it from happening again
It is important to avoid lifting or pulling your child up by the hands, wrists or forearms. Use the upper arms or arm-pits of your child to lift them up. Do not play games such as swinging your child by their arms as this may cause further injury and another pulled elbow.