My sister picked up my DD Monday by one arm and dragged her kicking and screaming "I don't want to go inside!" into the house to keep her from getting stung by a bee that kept hovering around her outside. Only moved her maybe 8 feet this way. DD complained that her arm hurt, but nothing "appeared" to be wrong with it. She kept favoring it all week, only using it if she had to use both hands, and would periodically complain it hurt and then later say it was better. But she was still whimpering at night if it got bumped so I finally brought her in to the doctor yesterday because her arm wasn't getting better. Apparently my DS pulled DD's elbow out of whack - or Nursemaids Elbow as we learned from Tricia earlier this year. The doctor bent her arm this way and that to pop it back into position and it appears to be fine now. Thankfully. They took 2 xrays to be sure there was no break and there didn't appear to be any.
It's interesting how an infant was put into a cast and a preschooler just gets it popped back into place and sent on her way.
So the moral of the story is - don't drag uncooperative children by one arm unless the damage cause by not doing so is worse than the potential damage caused by dragging them somewhere. I suspect it was a combination of being picked up by one arm and then fighting to escape that did it. (Of course, being 8 months pregnant makes it hard to pick up said uncooperative 33 lb 3-year-old.)
That is surprising to me that they were able to simply *pop* her arm back into it's proper socket, but thank goodness that's all it took. Having a toddler in a cast SUCKS!
Glad she's OK.
The Following User Says Thank You to Terri For This Useful Post:
That is surprising to me that they were able to simply *pop* her arm back into it's proper socket, but thank goodness that's all it took. Having a toddler in a cast SUCKS!
Glad she's OK.
After Tricia's experience with Tierney I was too. Though I think that's what they pretty much do with dislocated shoulders, at least in adults. Doctor thinks she was working it back into place when she used it the last few days.
Here's some more information about the injury. I always want to know more.
Quote:
Radial Head Subluxation (Nursemaid's Elbow)
Radial head subluxation, or nursemaid's elbow, is a very common injury of toddlers. It is usually caused by pulling on and twisting a child's arm. Often the child is pulled by the arm, or pulls himself away while his hand is being held, but the arm may be pulled when a child grabs something to break a fall, and I have seen a nursemaid's elbow in a child who was walking her dog and whose arm was pulled by the dog with the leash.
There are two bones in the forearm: the radius (on the thumb side of the arm) and the ulna (on the little-finger side). The heads, or upper ends, of these two bones are part of the elbow, and are "connected" to the humerus (the upper-arm bone) by several ligaments, which are bands of tough, flexible connective tissue. One of these ligaments, called the annular ligament because of its ring-like shape, is anchored on the head of the ulna but wraps around the head of the radius. This ligament is also connected to the radius, but not as well as to the ulna.
When your arm and hand are pulled and twisted, you can tear a small part of the annular ligament. When your arm is released after the pull part of the ligament is pinched between the head of the radius and the end of the humerus. This hurts. It also makes it hard for you to move the elbow without more pain. Usually a child with nursemaid's elbow hold the arm still to avoid pain; they may hold the affected elbow straight or a little bent, with the radial side turned inward (we call this pronation). She will be pretty comfortable unless you try to move her elbow or to turn the forearm back outward (supination). There is usually no swelling, but the radial side of the elbow may be a little tender.
Although we call this subluxation (partial dislocation) of the radial head, the radial head is not actually out of place -- it's just that the ligament is trapped in the joint. X-rays of the elbow are usually normal, since the radial head isn't really dislocated, and I usually don't get X-rays of nursemaid's elbows unless I can't reduce them or unless I think there may be another injury beyond the radial head subluxation.
Reducing a nursemaid's elbow is actually fairly simple once you have been shown how to do it once or twice. (Good thing, too, since once you've had one nursemaid's elbow there is a fair risk of having another subluxation in the same elbow.) When I reduce a nursemaid's elbow, I will often show parents how to reduce it themselves. In many cases the child's movement is enough to reduce the subluxation, or my moving the arm and elbow during examination reduces the subluxation without any other measures. You need to ask your own doctor about the procedure -- it's hard to describe over the Net without demonstrating. Rarely (I've never had to do it myself) a child's nursemaid's elbow cannot be reduced this way and an orthopedist has to take care of the problem; the chance of a fracture in a case like this is much higher, and X-rays are needed at this point to make sure that the radius and ulna are both intact.
Reading about this, I'm very surprised we haven't been down this path. It sounds mighty painful. I'm glad you got it taken care of.
If all a kid has to do to get this injury is pull away from you - it's amazing they don't all have it happen. I suspect it happened to her once before and she worked it back into place a few days later. It's hard to realize it's serious, because they can position their arm in such a way that is more or less comfortable as long as it's not bumped. Which is what she did. And she was using her arm when she had to. The first thing I did when she said it hurt was make sure she could move everything - and she could. Tricia had Tierney screaming in pain. Liriel didn't do that. No crying, no whimpering, just said it hurt. Then she went on her way doing other stuff when no relief was given. Later when asked she would say it was better. There was no swelling, no bruising, nothing. So you're thinking, OK, she must be getting better. Until you bump or grab her arm some time later and she briefly cries out in pain or just says you hurt her. Had I called the day it happened, they probably would have told me to give her Tylenol and if it didn't get better in 2 days to call back. When I did call it was just after the 72 hour mark where they want to see someone with an apparent mild injury that isn't improving. Of course now I will be forever paranoid.
09-05-2008, 12:04 PM
How not to carry your unwilling youngster
Doctor thinks she was working it back into place when she used it the last few days.
.) When I reduce a nursemaid's elbow, I will often show parents how to reduce it themselves. In many cases the child's movement is enough to reduce the subluxation, or my moving the arm and elbow during examination reduces the subluxation without any other measures. You need to ask your own doctor about the procedure -- it's hard to describe over the Net without demonstrating. Rarely (I've never had to do it myself) a child's nursemaid's elbow cannot be reduced this way and an orthopedist has to take care of the problem; the chance of a fracture in a case like this is much higher, and X-rays are needed at this point to make sure that the radius and ulna are both intact. 
