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What this means is that in order to pop the joint back in place, you need to replicate 1) and 2) again. There is a specific sequence of steps which allows you both to put sufficient traction on the distal end of the radius and torque it in the proper way to slip the head right back into joint at the elbow. Takes less than 2 seconds, if you know what you are doing.
And you get to feel like a miracle worker. Actually, that's the only time I've remotely felt like God as a physician. Heard a kid crying in the ER waiting room, walked out, saw the classic pose, asked "what happened?," reached out and fixed it, and then said "It's going to be all right. I'll see you when you get back to a room, just to make sure everything is okay."
By the time they get back to a room, the kid is playing normally, running around and laughing, using the arm just fine. The look on the parents' faces ... ah, a happy moment.
[ January 06, 2005, 10:27 AM: Message edited by: Sara Sasse ]
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Thanks Sara! I haven't played that form of the airplane game because I always heard that their shoulders can pop out of joint easily. I hold him under his chest and at the groin and "fly" him around the room. He likes to swoop down and grab things off the floor.
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My cousin did this to her daughter pretty recently. The girl has told everyone that her mother broke her arm.
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(If nothing like this has ever happened by the time they are six, can I just assume they have strong tendons or ligaments or whatever?)
-o-
Mango is a head banger too. Mostly, she does it when she is sleeping. It tends to freak people out. She had one Montessori teacher who didn't accept our answer of "She just does that. We don't know how to stop it," and swore she would get to the bottom of it.
Still haven't heard back from her.
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When a nursemaid's elbow happens, it usually happens in a child between 1 and 4 yrs old. It's rare after 6 yrs old, but a case of a 15-yr-old with a subluxed radial head has been reported in the literature.
As for head-banging, it can be associated with some underlying developmental problems, but it can just be habit. Takes a thorough work-up to be sure, but usually they won't hurt themselves. If they break their skin, bruise themselves, break a tooth, etc, then of course have them screened. If the child has other problems that concern you (lack of social behavior, missing developmental milestones, gastrointestinal distress, etc), then I'd bring it to the attention of a physician.
Or, just mention it at a well-child visit anyway. Get it off your mind.
[ January 06, 2005, 11:38 AM: Message edited by: Sara Sasse ]
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I had heard of nursemaid's elbow before, but Abigail is the only one of ours that's ever experienced it. She's not the one I would have expected, you'd think Daniel with his hyperflexic joints would be the one.
Though Abigail also had the hip click as an infant. *shrug* My doc said the same thing, Sara, that he loved nursemaid elbow because it was a fix he could accomplish right then. No take antibiotics and you'll be better in a few days, but "I can fix that for you right now."
He looked at me and said "She's going to yell at me for a second, but then she'll be all right." And she did - she didn't like the twisting motion he did one bit, but 10 seconds after that she was accepting a sticker from him and giving him a hug.
Then, on our well child visit a month later, she says to him "I don't want you to pull my arm again." He said "Oh you remember me hurting your arm, but you don't remember that I made it all better?" LOL
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Among the ER physicians, we'd fight amongst ourselves over who got to fix the patients with nursemaid's elbow. I claimed they were my cases because I was the pediatrician, but if I was in a room with another patient, the main ER physicians would poach 'em, and then they'd laugh.
Actually, I'm glad that the problem gets fixed as soon as possible, but I do admit to relying on the nurses to give me a heads-up when one was coming through. I brought treats and did nasty chores, and the nurses liked me best. Posts: 2919 | Registered: Aug 2004
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Oh, she's quite developmentally delayed . . . this is not a new thing, but a set of issues we've been dealing with forever. But nobody has suggested to us any "cures" for developmental delays other than time and nurturing to grow. We've mentioned the headbanging to various doctors and gotten results ranging from shrugs to reassurances that it's no big deal to the suggestion that we give her half a pill or so of Benadryl before she goes to sleep for a week or two. (I have not done this because it didn't feel right to me. What do you think of this advice?)
But it's a cart and horse thing. I mean, there are plenty of good reasons for her delays, but is her headbanging caused by her delays, or is her failure to develop caused (in part) by her unrestful sleeping patterns? Posts: 13680 | Registered: Mar 2002
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Oh, Dan, that's scary. Olivia popped out her elbow at 1 1/2, when hubby grabbed her by the time to pull her down off a counter. She can still hyerpextend her knees which is creepy.
Icarus, do you think Mango has sensory issues? Food intolerences? Those things sometimes to hand in hand with developmental delays.
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You purposefully made the title sound like you actually cracked a bone, didn't you. I'm glad to hear it's a simple and easy-to-fix dislocated elbow! (And it's good to know how easy it is to pop out a young child's elbow. I'll be carefull with my cousin now!)
How is Sasha feeling now? Does he seem upset about the whole thing?
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romany, I'm not aware of any food issues. Mango and Banana are both ravenous eaters, fwiw. We've always believed their delays are caused by the fact that they were born at 29 weeks gestation, with immediate, intense medical needs. I've suspected as well that their premature birth was caused by their birthfather's physical abuse of their birthmother, and who knows what ramifications in utero abuse may have had.
Zan, yeah. The thinking was that maybe we could put her into some sort of regular sleeping groove, I guess. Since I see her sleep issues as going hand in hand with their developmental issues, this just isn't all that convincing to me.
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Icarus, I know they are still little, and I am not sure if your SpEd laws are like ours in MASS. However, when a child turns nine(ten?) they are no longer labeled developmentally delayed. We have quite a few kids on our team whom we KNOW need services, but they have been signed off because there is no diagnosis once they turn nine(or ten) Just keep this in mind.
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Actually, that's the only time I've remotely felt like God as a physician. Heard a kid crying in the ER waiting room, walked out, saw the classic pose, asked "what happened?," reached out and fixed it, and then said "It's going to be all right. I'll see you when you get back to a room, just to make sure everything is okay."
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I haven't played that form of the airplane game because I always heard that their shoulders can pop out of joint easily. I hold him under his chest and at the groin and "fly" him around the room. He likes to swoop down and grab things off the floor.
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