2nd (and 1st!) Nursemaid's Elbow

Well, tonight was a second (and first) for me. A couple of weeks ago, one of my nursing staff asked me, "Can you see a two year old with a broken elbow?" I said that I could, as long as it was a non-operative fracture. Well, the father brought the little girl in, and the x-rays were taken before I got in the room. I reviewed them, and there was no fracture that I could appreciate... I went in the room to evaluate the patient, and found a cute little girl sitting there with her elbow partially flexed and hand pronated. A quick supination and flex later, I heard a satisfying "pop" and told Dad, "I'll be back in a few minutes." When I came back in, Dad had a big smile on his face, and the patient was climbing up on the stool using her previously useless arm. I explained she had a Nursemaid's Elbow, which occurs when the annular ligament slips between the humerus and the radial head. After it's reduced, the patient regains use of the arm quickly (within 10 minutes usually but it sometimes takes 30 minutes to return to full use) and are as good as new. There are few things I get to do that are as quickly satisfying.

Well, tonight, as I was getting Jax ready to go to bed, he started to pitch a fit while I was holding his left arm. He went to sit down, I went to pick him up, and I felt a "pop." He cried out and I looked- yep, his arm was flexed and pronated. I picked him up, flexed and supinated him, and heard another "click." Five minutes later, he was as good as new. However, it's not as satisfying when you're the cause of it in the first place... Hopefully, that's my last family reduction- if Jax continues the way he is, however, I somehow doubt it.