Epidemiologic Trends in Common Injury Mechanisms and Associated Consumer Products in Pediatric Radial Head Subluxation Cases.

Background: Nursemaid's elbow injuries occur in young children, with axial traction on the arm as a commonly-described mechanism. Prior demographic studies have noted a significant increase in this injury over the last three decades. We sought to examine incidence of nursemaid's elbow over time and assess the impact of COVID-19 on injury frequency. Additionally, certain household products and female gender have been frequently seen in cases presenting to emergency departments. The present study aims to further investigate injury scenarios to better understand the difference in injury rates and mechanisms. Methods: Using the National Electronic Injury Surveillance System database, this study analyzed 4,075 cases of nursemaid's injuries presenting to emergency departments from 2019-2023 in children from birth to six-years-old. The events' narrative case descriptions were searched for keywords to identify terms used to describe the injury. Cases were examined in groups by age, gender, location of the injury event, mechanism of injury ("fall" versus "pull"), and product involved. Results: There was no significant change in rate of cases during the time period, although there was a non-significant drop in 2020. Females had a higher incidence of injury. Two-year-olds represented the largest affected age group. Common injury mechanisms were "falls" (44% of events) and "pulls" (29%), with twisting motions rarely described. The most common household products involved in injuries were beds and bed frames (21% of cases). The higher incidence in females compared to males persisted across age groups, mechanisms, and most products involved, with the exception of more daywear-related "fall" injuries in males. Conclusion: Unlike previous studies, incidence of nursemaid's elbow did not statistically increase during the pandemic. Females continued to account for most injuries, a trend that remained largely stable when data were subdivided by product, age, and mechanism. This could be due to a possible anatomic difference in young female elbows compared to those of males, which represents an area for future investigation. Educating caretakers about nursemaid's elbow and implementing household safeguards may help prevent injury.