Pulled elbow in young children

A small bone at the elbow has slipped out from under its ligament.

In children under about five, that ligament is still loose. A sudden pull on the hand lets the bone slide out from under it. Nothing is broken and nothing is torn.

Because it stops hurting once the arm is still.

The typical child cries at the moment it happens, then settles, and simply refuses to use the arm, holding it slightly bent by the side. Parents often think the arm is paralysed. It is not.

Usually not — if it was a pull.

When the story is a clear pull on the hand and there is no swelling or bruising, it is put back without an X-ray. If there was a fall, or there is swelling, we X-ray first, because a fracture must not be put back by mistake.

It can, until about age five.

Some children have it two or three times. It becomes impossible once the ligament tightens with growth. Avoiding pulling on the hands is what gets you there.