Playtime can lead to common elbow injury in children: Luckily there’s a quick fix, doctors say

Medical Watch

CHICAGO — We’ve all swung our kids by the arms. Or we’ve watched siblings drag each other across the floor. It’s a playtime injury that pops up more often than you’d think.

For the Fergus boys it’s like this every day. Their mother, Rachel Fergus said the boys are really rough together. Their father, Alex Fergus, said they’re energetic and all love each other.

However, about six weeks ago, 2-year-old Rowan’s arm didn’t look quite right. His father said the boy was cradling it. His mother said he was propping it up and that he looked uncomfortable.

The parents asked Easton, Rowan’s older brother, who quickly explained what had happened. He said when Rowan didn’t want to get dressed, he dragged him to the bedroom.

“I think he felt some of that guilt, like ‘I hurt my brother,’ but we just reassured him, this is going to happen and if you didn’t hurt each other now it’s bound to in the future. Mommy and daddy could have even done it,” Rachel Fergus said.

At the ER, doctors diagnosed Rowan with nursemaid elbow, an old-fashioned name for an injury common among kids four years old and younger. Dr Jill Larson said they see about two cases a week at Lurie Children’s Hospital.

“So the radial head comes briefly out of the joint and that happens when the child hyperextends or pulls the elbow,” she said. “Often happens when yes a younger or older brother pulls an arm, sometimes parents swing kids.”

It happens where the radius bone meets the elbow joint.

“The ligament that is flexible in children is called the anular ligament, and it’s anular like, a ring, and it goes around the radial head and if it pops or moves out of place, it blocks the radial head from being in line with the joint and that is what’s causes a nursemaid elbow,” Larson said.

Thankfully, it’s a quick fix — a bend of the hand and a flex of the elbow pops things back into place.

“They did an X-ray to make sure everything looked ok and actually in X-ray is when they rotated it to get the image and they put the arm back in place and it was instant relief,” Rachel Fergus said. “Before we left the ER, he was Rowan, which is happy and crazy.”

“Some kids feel some irritation. some soreness or pain for a couple days after it happened and they may restrict the motion,” Larson said. “Usually a sling for comfort and anti-inflammatories is all we recommend.”

Even though the risk exists, Larson says don’t miss out on the fun — go ahead and swing your kids, just be aware of weight distribution.

“You just want to dissipate the forces as much as possible so when you are swinging your kids use both arms as opposed to putting all of the force on a single arm, and be aware of the amount of force you are using,” Larson said.

“If it didn’t happen now it would have happened in the future,” Rachel Fergus said. “I honestly didn’t know what a nursemaid injury was. Now that I know I kind of guard that arm.”

Children who suffer a nursemaid elbow injury may be more prone to having it happen again. In kids who have multiple injuries, the ligament can get stretched out and be problematic in the long-term.

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