Nanny's elbow: why the child stopped moving his arm after a jerk

Other names: Локоть няни, подвывих головки лучевой кости, вывих локтя у ребёнка, ребёнок не поднимает руку, пронационный подвывих, вытянули руку ребёнку

Subluxation of the radial head, called nursemaid's elbow, is the most common elbow injury in children one to five years of age. It occurs when a child is sharply pulled by the straightened arm: lifted by the hand, kept from falling, put on a jacket, or swung by the arms. The annular ligament, which holds the head of the radial bone, is still flexible in babies, and when jerking, it slips and is pinched in the joint. The child immediately stops using his arm, holds it along his body and cries when trying to bend his elbow. There is usually no swelling or bruising. The doctor realigns the joint in a matter of seconds, and mobility returns almost immediately.

🧾 МКБ-10: S53.0 🏥 Where it is treated: 8 Children from 1 to 5 years oldOccurs after a jerk on the armAdjusts in seconds

👨‍⚕️ Which doctor

Pediatric traumatologist-orthopedist, pediatrician

🔬 Diagnostics

Inspection is usually sufficient; X-ray of the elbow for injury, swelling or doubt

💊 Treatment

Closed reduction by physician, then observation; Pain relief is rarely required

📈 Prognosis

Excellent; after 5–6 years, subluxations stop

⚠️ At risk

Age up to 5 years, repeated episodes, habit of lifting the child by the hands

⏱ When to see a doctor

Urgent

🚨 See a doctor urgently

With these signs do not wait for a scheduled appointment — the condition requires emergency care.

Была не тяга за руку, а падение или прямой удар по локтю
Заметные отёк, кровоподтёк или деформация в области локтя
Ребёнок не даёт дотронуться до предплечья или плеча
Рука бледная, холодная или ребёнок жалуется на онемение пальцев
После вправления подвижность не восстановилась в течение получаса
Повторные эпизоды, возникающие без явного рывка за руку

Why does this happen in babies?

In young children, the head of the radius still has an almost cylindrical shape, and the annular ligament around it is thin and elastic. When you sharply pull on the hand or forearm with the elbow straight, the ligament slides up and is pinched between the head of the bone and the joint. After five to six years, the shape of the head changes, the ligament strengthens, and this mechanism stops working. This is why nanny's elbow almost never occurs in schoolchildren and never in adults.

Peak age: 1 to 4 years
Immature shape of the radial head
Elastic annular ligament
Mechanism - traction by straight arm
After 5–6 years the risk practically disappears

Typical situations and symptoms

Most often, parents remember that they suddenly lifted their child by the arms, kept him from falling, carried him over the curb, or pulled his sleeve. The child screams and then stops using his hand: it hangs along the body, slightly bent, palm turned down. The baby reaches for the toy only with his healthy hand. Externally, the elbow looks normal - there is no swelling or bruising, and this is an important distinguishing feature. Pain occurs when trying to bend the elbow or turn the palm upward.

The arm is hanging limply along the body
Palm facing down, elbow slightly bent
The child does not allow you to bend your arm and turn your palm
Externally the joint is not changed, there is no swelling
Crying when trying to move your arm
The child takes everything only with his healthy hand

Is a photo necessary?

If the story is typical and the elbow looks normal, an experienced doctor will make a diagnosis upon examination and immediately realign the joint. X-rays are prescribed when the mechanism of injury is unclear, there was a blow or fall, there is swelling, bruising, deformity, and also if the arm does not work after repositioning. The image is needed to exclude a fracture of the epicondyle of the humerus and the neck of the radius, which are treated completely differently. An ultrasound of the joint helps clarify the condition of the ligaments and find fluid accumulation.

Diagnosis is usually clinical, based on a typical history
X-ray of the elbow joint in case of a fall, swelling or deformity
X-ray in case of unsuccessful reduction
Ultrasound of the joint to evaluate ligaments and effusion
Examination of the collarbone and shoulder to rule out other injury

How to set an elbow

The procedure takes a few seconds and usually does not require any pain relief. The doctor holds the elbow, presses the head of the radius with a finger and performs one of the standard movements: flexion with palm up or full palm down with extension. At the moment of reduction, a characteristic click is felt. The child cries briefly, and after 10–20 minutes begins to use his hand again - reaches for a toy, raises his hand above his head. If after half an hour the movements have not been restored, take a photo and try again. Plaster and fixation are usually not needed after reduction.

Inspection and check for signs of fracture
Reduction by one of two techniques, often with a click
Control of movement recovery after 10–30 minutes
Re-reduction or x-ray if unsuccessful
Fixation with a bandage only for repeated episodes
Pain relief is rarely required

Prevention of repetitions

After the first episode, the likelihood of repeated subluxation in the coming months increases, so the main thing is to change the habits of handling the child. The baby is lifted under the arms or by the torso, and not by the hands and forearms. You should not swing the child by the arms, sharply pull him by the sleeve or hold him by the wrist when he falls. When putting on a jacket, first gently bend the elbow, and then thread the sleeve. As the child grows up, the problem disappears: by the age of six, subluxations practically do not occur.

Lift the child under the arms, not by the hands
Do not swing your arms or tug on your sleeve
Dress and undress carefully, bending your elbow
Warn grandmothers, nannies, and older children about the rules
In case of repeated episodes, consult a pediatric orthopedist

Services and prices for this diagnosis

Based on official price lists of Tashkent clinics. The exact cost is determined after examination.

🔬 Diagnostics

Рентген локтевого сустава (в 2 проекциях)УЗИ суставов Первичная консультация педиатра

Frequently asked questions: Subluxation of the radial head in children (“nanny's elbow”)

Is it possible to straighten a child’s elbow yourself?+

Not worth it. Fractures in the elbow area give a similar picture, and improper manipulation can displace the fragments. In addition, if the attempt is unsuccessful, the ligament is pinched more strongly. It is more correct to take the child to a traumatologist; this is a simple and quick procedure.

Does it hurt the child when adjusted?+

The moment of reduction is unpleasant, the child usually screams, but the pain goes away almost immediately. Anesthesia is usually not required. After 10–20 minutes, the baby begins to use his hand as usual.

Is a cast needed after reduction?+

During the first episode - no. The joint is stable, and a gentle regime for a day or two is enough. A bandage for several days is sometimes prescribed for repeated subluxations, so that the ligament has time to recover.

Why does subluxation recur?+

In the first weeks after the episode, the annular ligament is still stretched, and less force is sufficient. Recurrences occur more often in children with increased elasticity of the ligaments. With age, the tendency disappears; if episodes are frequent, the child should be shown to a pediatric orthopedist.

How to understand that this is not a fracture?+

With Nanny's elbow there is no swelling, bruising or deformity, pain occurs only with movement, and the history almost always involves a tug on the arm. If a child falls or hits himself, the elbow is swollen and changes shape, an x-ray is needed; such an arm cannot be reset.

The information on this page is for reference only and does not replace a doctor consultation. Only a qualified specialist can make a diagnosis and prescribe treatment after an in-person examination.

Where it is treated subluxation of the radial head в Ташкенте

Вправлять локоть ребёнку самостоятельно нельзя: под похожую картину маскируется перелом. Clinics Ташкента, где принимают детские травматологи и педиатры:

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