In this episode, we review nursemaid's elbow, also known as radial head subluxation, a common upper extremity injury in young children. We discuss the typical mechanism—sudden traction on an extended arm, such as when a child is lifted or swung by the hand—which causes displacement of the annular ligament around the radial head. The episode highlights classic clinical findings including a child holding the arm slightly flexed and pronated while avoiding movement due to pain. We also review the primarily clinical diagnosis, when imaging may be necessary, and the simple but effective treatment of closed reduction, after which most children regain normal arm use within minutes. Key clinical pearls include the high recurrence rate and the importance of prevention, particularly avoiding pulling or lifting young children by the arms.

References

1. Bushardt RL, Colomb-Lippa DM, Klinger AM, Reed H. The JAAPA QRS Review for PAs: Study Plan and Guide for PANCE and PANRE. 1st ed. LWW; 2021. ISBN: 9781975143817.
2. Nardi NM, Schaefer TJ. Nursemaid Elbow. [Updated 2023 Aug 14]. In: StatPearls [Internet]. Treasure Island (FL): StatPearls Publishing; 2026 Jan-. Available from: https://www.ncbi.nlm.nih.gov/books/NBK430777/
3. Shaath K, Shirley E. Nursemaid's elbow. Orthobullets. Updated August 21, 2022. Accessed March 9, 2026. https://www.orthobullets.com/pediatrics/4012/nursemaids-elbow