Friday, November 14, 2008

Radial head subluxation

In 17 and 1/2 years and 6 kids, we have never before suffered a fractured bone or dislocated anything....except for Michael, who is having surgery next month to correct a torn ACL..........

There's a time for everything, though, and this week was our time to learn how to fix a nursemaid's elbow.....twice. Both times, Eamon was rough-housing with a big brother.

Nursemaid's elbow is a partial dislocation of the elbow, which occurs when the lower part of the arm (forearm) slips out of its normal position at the elbow joint.
The injury is also called radial head dislocation.

Causes
Nursemaid's elbow is a common condition in young children and generally affects children under age 5. The injury occurs when a child is pulled up too hard by the hand or wrist. It is often seen after someone lifts a child up by one arm up. (For example, when trying to lift the child over a curb or high step.) Swinging a young child from the arms while playing can also cause this injury.
Once the elbow dislocates, it is likely to do so again, especially in the 3 or 4 weeks following the injury. THEY DIDN"T TELL US THAT IN THE ER!

Symptoms
Immediate crying - UNTIL HE GOT HIS ARM INTO A BEARABLE POSITION. AT THAT POINT,HE WANTED TO GO BACK TO PLAYING!
Refusing to use the arm that is injured
Holding elbow slightly bent at the elbow
Holding the lower part of the arm against the belly area (abdomen) AS EAMON DID!
Moving arm at shoulder but not elbow
If you think your child has nursemaid's elbow:
DO NOT move the child without first splinting the arm.
DO NOT try to straighten the arm or change its position.
Apply an ice pack to the elbow. Splint the injured arm in the position in which you found it. Keep the area both above and below the injured elbow from moving, including the shoulder and the wrist, if possible.
Take the child to the doctor's office or emergency room.
OR BOTH ON CONSECUTIVE NIGHTS!

Treatment
The doctor will fix the dislocation by gently flexing the elbow and rotating the forearm so that the palm is facing upward. DO NOT try to do this yourself as you may harm the child.
In some cases of frequently recurring nursemaid's elbow, your health care provider may teach you how to attempt to correct the problem yourself. See your health care provider for assistance.

Avoid lifting a child by one arm only, either from the wrist or hand. Lift from under the arms, from the upper arm, or from both arms. Do not swing children by the hand or forearm. To swing a young child in circles, provide support under the arms and hold the upper body next to yours.

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