Nursemaid Elbow: Child Abuse?

[Holey Mike MFD]

Hey Dr.Steve I'm enjoying the show keep up the good work. I'm writing out of concern for our 2 year old grandson. My stepson recently moved in with his new girlfriend and took his 2 year old sin with him. They brought the grand baby over for a visit and my chick noticed he was favoring his left arm and if you tried to see what was wrong he would shriek in pain.and would not let you touch it. His dad tells us he fell in toy room and he'll take him to Drs office on Mon. We said BS he's in pain take him to the ER now. He took the boy to the ER but they couldn't get a good Xray (he wouldn't hold still) so they put him in splint and half cast and said he had a dislocated elbow and he should see a specialist on Mon. Now ever since this incident new girlfriend has been real distant to the rest of us without anyone even accusing her of anything.She was always friendly and outgoing before now she won't even enter our home she waits in the car .Also we know she is a self cutter but we never thought nothing of it till now. We are suspecting the new girlfriend grabbed him roughly it just seems like this kind of injury wouldn't be consistent with a solo play time accident and I was wanting your opinion on this type of injury. If working the ER would you find the parents story to be suspect with this kind of injury? As far as we know ER doc didn't raise issue but everyone who cares about this boy feels the sam way I do about the new girlfriend. Were not sure what to do about this without getting stepson into more trouble as he is already behind on his child support.Maybe I should wait till mon after they get some Xrays and know more but I was just wandering about your experiences with detecting abuse in the medical setting.Thank you in advance and as always you rule for doing this for the listeners.

[Holey Mike MFD]

Hey Dr.Steve I'm enjoying the show keep up the good work. I'm writing out of concern for our 2 year old grandson. My stepson recently moved in with his new girlfriend and took his 2 year old sin with him. They brought the grand baby over for a visit and my chick noticed he was favoring his left arm and if you tried to see what was wrong he would shriek in pain.and would not let you touch it. His dad tells us he fell in toy room and he'll take him to Drs office on Mon. We said BS he's in pain take him to the ER now. He took the boy to the ER but they couldn't get a good Xray (he wouldn't hold still) so they put him in splint and half cast and said he had a dislocated elbow and he should see a specialist on Mon. Now ever since this incident new girlfriend has been real distant to the rest of us without anyone even accusing her of anything.She was always friendly and outgoing before now she won't even enter our home she waits in the car .Also we know she is a self cutter but we never thought nothing of it till now. We are suspecting the new girlfriend grabbed him roughly it just seems like this kind of injury wouldn't be consistent with a solo play time accident and I was wanting your opinion on this type of injury. If working the ER would you find the parents story to be suspect with this kind of injury? As far as we know ER doc didn't raise issue but everyone who cares about this boy feels the sam way I do about the new girlfriend. Were not sure what to do about this without getting stepson into more trouble as he is already behind on his child support.Maybe I should wait till mon after they get some Xrays and know more but I was just wandering about your experiences with detecting abuse in the medical setting.Thank you in advance and as always you rule for doing this for the listeners.




I just wanted to say thanks but we found out who did this and we're gonn follow up on this. We knew the cover story was weak and we got a non coerced confession.[/B]

[Dr Steve]

Hey Dr.Steve I'm enjoying the show keep up the good work. I'm writing out of concern for our 2 year old grandson. My stepson recently moved in with his new girlfriend and took his 2 year old sin with him. They brought the grand baby over for a visit and my chick noticed he was favoring his left arm and if you tried to see what was wrong he would shriek in pain.and would not let you touch it. His dad tells us he fell in toy room and he'll take him to Drs office on Mon. We said BS he's in pain take him to the ER now. He took the boy to the ER but they couldn't get a good Xray (he wouldn't hold still) so they put him in splint and half cast and said he had a dislocated elbow and he should see a specialist on Mon. Now ever since this incident new girlfriend has been real distant to the rest of us without anyone even accusing her of anything.She was always friendly and outgoing before now she won't even enter our home she waits in the car .Also we know she is a self cutter but we never thought nothing of it till now. We are suspecting the new girlfriend grabbed him roughly it just seems like this kind of injury wouldn't be consistent with a solo play time accident and I was wanting your opinion on this type of injury. If working the ER would you find the parents story to be suspect with this kind of injury? As far as we know ER doc didn't raise issue but everyone who cares about this boy feels the sam way I do about the new girlfriend. Were not sure what to do about this without getting stepson into more trouble as he is already behind on his child support.Maybe I should wait till mon after they get some Xrays and know more but I was just wandering about your experiences with detecting abuse in the medical setting.Thank you in advance and as always you rule for doing this for the listeners.

Sounds like a "Nurse Maid Elbow" injury...the people in the ER should have recognized this immediately, though. It occurs after a jerking motion to the arm and can happen in the absence of abuse when a kid's hand is being held and he/she jerks away from the hand holder. It's very easy to reduce by simply rotating the forearm while extending it fully.

The adult who caused this to happen will often feel extremely guilty and feel that they abused the child (and maybe they did, only a retrospectoscope (time machine) would prove that).

If doctors suspect child abuse, they're obligated to report it. I can't say much more without knowing more, but child abuse is preventable when detected early.

here's an article on nursemaid elbow: http://www.emedicinehealth.com/nursemaid_elbow/article_em.htm

here's an article on detecting and reporting child abuse: http://www.preventchildabuse.org/help/recognize_warning_signs.shtml

good luck and let me know how it turned out.



steve