Looking after a Child with a pulled elbow.
A pulled elbow is an injury that occurs in children usually under the age of five. It results from a pulling injury to the child’s arm. Pulling the child up by his/her hands, swinging them from their hands or the child stumbling whilst having their hand held may cause the injury.
The child usually has pain in the elbow and holds the affected arm limply at his or her side. It occurs because the child’s joint has not fully developed and one of the ligaments at the elbow does not hold the bone tightly enough. It is not a full dislocation of the elbow, just a small movement from the normal position which can’t even be detected on X-ray
If the mechanism of the injury is clear, an X-ray is usually not necessary. The doctor or nurse practitioner will carry out a simple manipulation to put the bone back into the correct position. This can cause momentary pain for the child – simple pain relief by mouth may be given if necessary.
Most children resume normal use of the arm quickly after the manipulation. However, if the elbow has been ‘pulled’ for a while, the child may use it less than normal. In these circumstances we recommend regular pain relief for the child (paracetamol or ibuprofen) and to return to hospital if the child is still not using their arm normally after 3 days.
It is important to be aware that a child who has had a pulled elbow once is at risk of it happening again. You should be careful not to pull your child up by the hands – always lift them under the arms. Also, avoid swinging them around by the forearm or hand.
Children grow out of this condition usually by about the age of five. It is not known to predispose to any risk or problems with growth or development of the elbow or indeed arthritis in later life.
The Trust recognises the importance of multi-agency working: to safeguard children and young people.
‘Protecting children is everybody’s business’
