Can Telemedicine Treat Nursemaid’s Elbow (Radial Head Subluxation)? - Triage Guidance

Audience: pediatric

Nursemaid’s Elbow, also called radial head subluxation, is a common injury in young children where the elbow joint partially slips out of place. It often happens when a child’s arm is pulled suddenly. This injury causes pain and the child may not want to use the arm. Telemedicine can be helpful to guide parents or caregivers through recognizing symptoms and deciding if medical care is needed. A healthcare provider can assess the situation through video and recommend next steps. However, some cases require in-person care for safe and effective treatment. This guide explains what telemedicine can and cannot do for Nursemaid’s Elbow, signs to watch for that need urgent care, and how to prepare for a telemedicine visit. It is important to remember that this information is educational and not a substitute for professional diagnosis or treatment.

Red flags — go in person / ER

• Child cannot move the arm at all or shows severe pain even at rest — seek emergency care immediately.
• Visible swelling, bruising, or deformity around the elbow — get urgent in-person evaluation.
• Injury caused by a fall, direct blow, or other trauma — prompt medical assessment is needed.

What telemedicine can do

• Assessing history and symptoms of suspected Nursemaid’s Elbow.
• Guiding parents on initial care and observation.
• Determining if urgent in-person care is needed.
• Providing advice on pain management and follow-up.

What telemedicine cannot do

• Performing the physical reduction (manipulation) of the dislocated bone.
• Diagnosing fractures or other serious injuries requiring imaging.
• Managing complications or repeated dislocations without in-person examination.

What is Nursemaid’s Elbow?

Nursemaid’s Elbow happens when the small bone in the elbow (the radius) slips out of its normal position. This usually occurs in children under 5 years old when their arm is pulled or twisted suddenly. The child may hold their arm straight and refuse to use it because of pain.

How Telemedicine Can Help

Through video calls, healthcare providers can ask about how the injury happened and watch the child’s arm position and movement. They can help decide if the injury looks like Nursemaid’s Elbow and if it is safe to try simple first steps or if the child needs to see a doctor in person.

When In-Person Care is Needed

Some signs mean the child should be seen in person quickly. These include severe pain, swelling, bruising, inability to move the arm at all, or if the injury happened with a fall or other trauma. In-person care may involve gently moving the bone back into place, called reduction, which should be done by a trained professional.

Preparing for a Telemedicine Visit

Have the child’s arm visible on camera. Be ready to describe how the injury happened and the child’s symptoms. Keep the child calm and comfortable during the visit. Have a phone or device ready in case the provider needs to call or send information.

After the Telemedicine Visit

Follow the provider’s advice carefully. This may include monitoring the child’s arm, giving pain relief, or visiting a clinic or emergency room if symptoms worsen. Watch for any new signs like fever, increased pain, or changes in arm color or temperature.

How to prepare for your tele-visit

• Ensure a stable internet connection and device with video capability.
• Have the child’s arm visible and well-lit for the provider to observe.
• Be ready to describe how the injury happened and the child’s symptoms.
• Keep the child calm and comfortable during the visit.
• Have any previous medical information or notes handy if relevant.

After your tele-visit

• Follow the healthcare provider’s instructions carefully.
• Monitor the child’s arm for pain, swelling, or changes in movement.
• Use recommended pain relief methods if advised.
• Seek in-person care if red flags or worsening symptoms appear.
• Schedule follow-up appointments if suggested by the provider.

FAQs

What causes Nursemaid’s Elbow?

It often happens when a child’s arm is pulled suddenly, such as when being lifted by the hand or swinging by the arms.

Can Nursemaid’s Elbow heal on its own?

Sometimes the arm may improve with rest, but often the bone needs to be gently moved back into place by a healthcare provider for quick relief.

Is Nursemaid’s Elbow serious?

It is usually not serious if treated promptly, but untreated cases can cause ongoing pain and limited arm use.

Can telemedicine providers fix Nursemaid’s Elbow?

Telemedicine providers can guide you but cannot perform the physical procedure needed to fix the injury; this requires in-person care.

When should I go to the emergency room?

If your child cannot move the arm, has severe pain, swelling, bruising, or if the injury was caused by a fall or trauma, seek emergency care immediately.

Sources

1. Radial Head Subluxation (Nursemaid's Elbow) — MedlinePlus, U.S. National Library of Medicine.
2. Nursemaid's Elbow — Mayo Clinic.
3. Radial Head Subluxation — American Academy of Pediatrics.
4. Telemedicine: What You Need to Know — Centers for Disease Control and Prevention (CDC).

This telemedicine guidance is for educational purposes only and is not a substitute for professional in-person medical care, diagnosis, or treatment. If you have concerns about your child’s health, please seek direct medical evaluation promptly.