If your child refuses to use her arm or leg, you should bring your child to the office for an appointment. A limping child who has no fever and is not in much pain should be evaluated if the limp has failed to disappear after 24 hours. More severe pain of either the arms or legs, especially after trauma, should prompt a visit for an X-ray examination of the affected limb. Any swelling, redness or pain in a joint, associated with fever, is a cause for immediate concern and the physician should he notified.
In-toeing and out-toeing when a youngster walks is a common problem in pediatrics and should be discussed at the time of a routine checkup. It is generally of little concern unless severe.
Nursemaid’s elbow: Nursemaid’s elbow or pulled elbow, as it is sometimes called, is a dislocation of one of the two forearm bones, the radius, from it’s normal position in the elbow joint. It is often caused by a sudden pull on an extended, pronated (inwardly turned) forearm, usually by an adult. This commonly happens to a two year child while they are being swung by the arms by and adult or teenager during play. The technical term for the injury is radial head subluxation. This condition is treated at the office by relocating the bone with a specific orthopedic maneuver. X-rays are generally not needed. A visit to the office during regular office hours is advised. If it happens at night, we would recommend going to the emergency room for treatment. Once a child has a pulled nursemaid’s elbow, you should not hold that hand while walking for several weeks to allow healing.