Radial Head Subluxation (Pulled Elbow, Nursemaid's Elbow)

Rear view of elbow joint showing bones and ligaments.The elbow is a joint composed of 3 bones held in place by strong ligaments (bands of tissue). One ligament is looser in young children than in adults. As a result, soft tissue may become trapped between the bones in a child's elbow joint. The medical name for this injury is radial head subluxation. It usually happens when a child is lifted or pulled by one arm.

Risk factors

Children under age 4 are most likely to have a radial head subluxation. As children grow older, their elbow ligaments become stronger. For that reason, this injury rarely happens after age 6.

When to go to the emergency room (ER)

A radial head subluxation causes sudden pain. In addition, your child won't be able to flex his or her elbow. The injured arm is likely to hang loosely at your child's side, and the child will not move or use it. If your healthcare provider can't see the child right away, go to the nearest emergency room.

What to expect in the ER

A healthcare provider will examine the injured arm. An X-ray may be taken. The healthcare provider will then gently move the joint to release the trapped tissue. Your child can sit on your lap facing the healthcare provider while this is done. It's likely to hurt for just a minute. Your child will be fine once the parts of the joint are all back in place. Most often, no other care is needed.

Preventing a pulled elbow

These tips can help prevent radial head subluxation in a child:

  • Lift your child under the arms—not by the hands or wrists.

  • Don`t swing your child by the arms.

  • Don`t pull your child by the hand or arm, even when you`re in a hurry.