Nurse maid elbow

So, one of Jacks loving uncles was swinging him by the arms the other night at the fair. On Saturday morning Jack would not use his left arm at all. I thought maybe he just had a sprain or something so we gave him Tylenol and kept going through the day, we kept thinking he was guarding it and we iced it. He would say "mommy my arm hurts" and at the Ute Football game he would not even put to much pressure on it. He did not cry a lot about it and I figured if it was broken or something he would be crying a lot more. My dad did a "Papa" check on it and thought that we should give it one more night and see if it rested enough he would be better in the morning. NOPE, this morning he was still in obvious pain and complaining about it. Ky leaves town today for another week and I was worried about her not being here if it was something more serious. So I decided that I would take him to the urgent care clinic at least to have it x rayed. He was so good laying under that big machine, it obviously hurt to have them turn it all over the place but he was a little champ (I thought to myself, well this is not going to be the last time you are sitting in this position you have a little boy so you better get used to it). They took us back to the room and Dr. W came in and says so... "what can I do for you, his bones look great?' Immediately I felt relief wash over me, but what was wrong then, the poor kid can not even get food to my mouth. The doc says "well I think it is nurse maids elbow, let me look" He grabs his arm and starts twisting, my mother who was with me hits the doctor and says "stop it you are hurting him." Jack of course was screaming. The doc "well I didn't get anything that time let me try just once more." I was cringing I knew it hurt Jack, the kid can lay himself out on asphalt and stand up and brush his hands off and keep going. The doc grabs his arm once more and twists and sure enough "POP" the doc says "Oh, I got it!" I could tell it felt immediately better. So the doc told us to hang out for ten minutes force Jack to use it so we could make sure there was a difference. So we went to the lobby and what makes a kid move better then anything but candy. Sure enough the boy was back to normal and announces to the doctors office "my arm feel better.' The doc checked him over one last time, Jack thanked everyone walking out of the office and it was so nice to have him back to normal. The doc spoke to us about why this happens and I looked it up and am posting it below so you can all see, he says it can simply happen from a child holding hands with Mom in a hurry, but mostly from picking them up and swinging them by their arms. We know this and have told this loving uncle NO MORE many times but guess you can't resist horseplay with boys.


Nursemaid Elbow Overview
Nursemaid elbow is a common injury among preschool-aged children. It refers to a condition (medically called a radial head subluxation) in which a child's elbow bones get partially pulled out of joint and do not line up normally. The injury can occur innocently from swinging a young child by the arms or pulling a child's arm while in a hurry.
A temporary condition without permanent effects, it can be quite frightening to parents who find their child lacking the ability to use his or her upper arm.
Specifically, a portion of soft tissue, whose function is to hold bones together, is pulled between 2 areas of the bones that make up the elbow joint. The involved bony areas are the radial neck and head of the radius bone in the forearm and the capitellum portion of the humerus, or upper arm bone. Movement of the elbow in this condition results in pain and keeps the child from using the upper arm.
Typically, this type of injury occurs in children aged 1-4 years but has occurred in infants aged 6-12 months as well. As children grow, their bones become larger and more defined. So this injury is rarely seen in children older than 6 years.

Nursemaid Elbow Causes
Nursemaid elbow occurs after a sudden pulling force is applied to the extended upper arm of the child while the arm is slightly twisted. The force may not seem strong, and you may not even realize it has happened.
Some examples of typical situations that can produce the mechanism of force required to cause this injury are these:
In lifting the child by the hand
Swinging the child while holding the child by the hands
Pulling arms through the sleeves of jackets
Catching a child by the hand to prevent a fall
Pulling a child along when in a hurry
The young child is prone to this type of injury largely because of the anatomical features of their bones and ligaments. Understanding the mechanism of this injury is helpful in explaining the cause.
The end of the radius bone that connects to the elbow joint is known as the radial head. This will eventually become shaped like the end of a dowel rod. In the young child, however, it does not yet have a well-defined lip at its end. As such, the radial neck and radial head portions of the radius are similar in size in the toddler.
The annular ligament holds the radius alongside the ulna, which is the other bone in the forearm, and allows for the radius to twist. At this point in childhood development, it is still relatively loosely attached to the bone and can experience a small tear in some of its fibers.
The combination of these 2 things allows the loose portions of the ligament to slide over the radial head as a pulling force is applied to the elbow when the forearm is slightly twisted inward (pronation). When this happens, this tissue can become trapped between the 2 bones, resulting in the subluxation of the radial head, or nursemaid elbow.