Nanny Elbow

Nanny’s elbow is a common injury among young children. It usually occurs when the arm is pulled with the elbow in full extension (open position). The child will not want to use the injured arm because it is painful to move it. They will hold the arm straight or with a slight bend in the elbow. It is important to consult a doctor as soon as possible. Most of the time it does not lead to long-term problems.

What causes nanny elbow?

Young children have a ligament in the elbow that is a little loose. Sometimes during play or when they are lifted by the arm, the two bones in the elbow can separate slightly for a short time. This causes a ligament to slip into the joint and then tighten. In other words, the articular surface of the radius (forearm bone) with the elbow resembles a shaft, which needs to be fixed by a ligament called the annular ligament to hold it in place during movement. In childhood, this joint is not sufficiently developed, so when the arm is pulled in the long axis, the ligament can easily peel away from the circumference of the head and cannot prevent a partial dislocation of the elbow. The result is nanny’s elbow.

What are the symptoms and how to recognize them?

With nanny elbow, the dislocation is very painful. Children usually try to hold the elbow joint immobile, with the back of the hand facing the face. Especially turning the palm of the hand towards the face increases the pain significantly. There is swelling and tenderness in the elbow joint. When the history of the injury is questioned, pain and loss of movement that occurs suddenly with pulling the arm plays an important role in the diagnosis. If there is no pulling of the arm, an X-ray is recommended before any intervention in order not to miss fractures around the elbow.

How is nanny elbow treated?

After the diagnosis is made, the physician places the dislocation in place with a special maneuver. This maneuver is called nanny elbow reduction. No anesthesia is required for this. Once the head of the radius (forearm bone) is in place, the child is relieved and can use the elbow as before in a short time.

What are the precautions?

It is important for parents to be aware of this childhood dislocation and to know that they should never lift their child by the arm until they are 6 or 7 years old. Always lift your child by the armpits, not by the hands or arms. Otherwise, nanny’s elbow can easily recur. When treated well, this injury does not leave any permanent disability related to the elbow.