By Registered Health Visitor – Julia Headland

What is a Dislocation?

A dislocation occurs when extreme force is put on a ligament, allowing the ends of two connected bones to separate. Ligaments are the flexible bands that connect various bones and cartilage and they are also what binds the bones and the joints together. Dislocation is not common at all in younger children because their growth plates are weaker than the muscles and tendons and therefore dislocations are much more common amongst teenagers. What is very common in toddlers is a pulled elbow.

Pulled Elbow

A pulled elbow is a really common injury in a child under the age of 5 and is often referred to as a ‘nursemaid’s’ elbow. A pulled elbow occurs when the lower arm (the radius bone) becomes partially dislocated or slips out of its normal position at the elbow joint. The strong stretchy band that is the ligament normally holds the radius bone in place but after a fall or sudden pull, the ligament can be overstretched and the bone partially slips out from underneath the ligament.

Causes

  • One of the main causes is when there is a sudden pull on a child’s arm or wrist and in particular, when a child is lifted up off the ground by one arm.
  • Another cause can be if a child falls over on to an out stretched hand.
  • Swinging a child by the arms or hands
  • Yanking on a child’s arm to make them walk faster
  • Pulling a child’s arm through a sleeve

Signs and Symptoms

  • Pain – no doubt the first thing that will happen is that the child will cry.
  • The child will not use the affected arm.
  • You may notice that their arm may just hang by their side.
  • The elbow may be slightly bent and the palm may be turned towards the body

Treatment

It is really important that if you suspect your child has a pulled elbow that you seek medical treatment from the GP surgery or the hospital or A&E. The reason for this is that the longer the elbow has been out of place, the more difficult it is to put back into place and it may take longer to recover.

The partial dislocation will be reduced which means that it will be manipulated back into place. Unfortunately, this can be quite painful and distressing but thankfully it only lasts a moment and is over when the radial bone pops back into place.

Often the child is able to move his arm straight away however if the elbow was partially dislocated for a while before treatment, they may have some pain for a couple of days for which they can be treated with pain killers.

Prevention of pulled elbow

Some children may be more at risk than others to get pulled elbow and it may happen more than once, particularly if a child has loose joints.

The most important thing you can do to prevent a pulled elbow or partial dislocation is not to pick your child up by the lower arms or wrists, always pick them up from under their armpits.

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For those people I have not yet met, my name is Julia Headland and I am a registered health visitor and registered general nurse with a degree in public health and over 20 years of experience.  I am very pleased to work alongside the Norfolk House Nursery team.

You can arrange to meet me for confidential advice or guidance about your child’s health or development; during the pandemic these consultations are being conducted by Zoom or telephone.

My consultations are free of charge and they are confidential.

You can book an appointment with me via the Norfolk House Nursery staff.

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