Nursemaid's Elbow

On Tuesday morning, Lily and Jack were wrestling in the family room when Lily “jumped” on top of him, Jack hears a snap, and starts crying. Coming from the Cota school of child rearing, I responded, “Ah, quit yer babblin’ and get up off the floor!”

A couple minutes later I found him lying on the living room couch, being very, very careful not to move his arm. Now, because I’m no dummy and (as I mentioned) come from the Cota school of child rearing, I grabbed it in various places asking him, “Does it hurt here? How ’bout here?” Between the sobs and screams, I determined the cause of the pain was near his elbow. This evidence also went along with his initial cry after Lily got up off of him. He had said, “Ow! Lily hurt my elbow!”

So while I was concerned that his arm was broken, it didn’t seem likely since there weren’t any bones sticking out and it wasn’t all that malformed. Also, it hadn’t started swelling yet and there was no bruising. Still, he wasn’t moving it, didn’t want anyone touching it, and was intermittently spiking on the pain scale. Plus, this is a kid that bounces back from all sorts of injury in moments, and this was beginning to linger.

Oddly, WebMD.com wasn’t my next move (which it would have been under normal circumstances. “Normal” being coughs, vomiting, kidney stones…) So I called his pediatrician who informed me that their office would be closing in 10 minutes (we did have 11 inches of snow, she reminded me.) I called the immediate care center to see if they had the necessary goods to take care of him in the event that his arm turned out to be broken. They recommended that I take him to the emergency room, where a pediatric ortho would be available if needed. “Great,” I mumbled, calculating the multiplier that accompanies walking through the doors of the ER. I briefly contemplating just amputating the arm with a hacksaw, but Char shot me one of those looks so I relented.

I carried Jack to the truck, turned on the four-wheel-drive, and off we went. There were three other vehicles on the road, two were snowplows and one was stuck in a snow drift.

Fast forward about half an hour. The doc walks in and begins asking Jack what happened. Let’s see… small kid turns up on a cold, blustery morning with a mysterious injury to his arm… I’m sure social services were on speed dial at the nurse’s station, and a finger was very likely hovering over the button. Jack seemed to convince them that I hadn’t snapped his arm and seemed to be showing no signs of shaken-toddler-syndrome, so they took the cuffs off me and attended to his arm.

“It might be broken,” said the doctor, “but it might also be Nursemaid’s Elbow.”

Now, like me, you’re probably thinking, “What the heck is Nursemaid’s Elbow?”

Turns out the head of the radial bone can get dislodged from the elbow joint with a strong blow to the arm/elbow and/or pulling on a kid’s arm. (Note to self: no more swinging the kids by their arms.) He said it’s fairly common in kids under three, and — Gee, don’t you know — we just had a kid in here yesterday with it. It can be fixed by extending the arm out away from the body and then bending the arm and moving the hand up toward the shoulder. It sometimes fixes itself when they’re taking X-rays. Which, of course, is what happened with Jack.

While I was moving his arm to get into position for the third X-ray (now I don’t think they were even taking pictures, I think they tricked me into being the one to fix it so I had to deal with the pain I was causing him…) the look on his face changed and it was done.

He hopped off the table and was walking back to the room normally, happily swinging his arms. “Dad,” says he, “they fixed it!” Sure enough, he was perfectly fine. No ill effects, no swelling, no tenderness… nothing. It was like it never happened.

The doctor came back in the room, saw Jack sitting on the bed coloring, and smiled. “You were right,” I said, “it slipped back in taking the X-rays.”

“I’m glad,” he said, clearly showing signs of relief. “If it doesn’t, I have to manipulate it back into place while the kid screams and the parents look at me wondering what the heck I’m doing to their child.”

Hmmm… “So, Doc,” I asked. “Since I’m technically the one who fixed it, can I just bill myself?” Still waiting for an answer to that, but my hope is fading.

Anyway, Jack is perfectly fine, like nothing ever happened. Weird.

[More about Nursemaid’s Elbow]

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