Nursemaid's Elbow in Children: Proposal of a Preventive Strategy in the Digital Era.

Abstract

Background Nursemaid's elbow, or painful pronation of the elbow, is a common orthopedic condition in children aged 0-5 years. It is typically caused by sudden traction on the forearm, leading to subluxation of the radial head. Despite its benign nature and straightforward treatment, the condition remains frequent, largely due to insufficient awareness among parents and caregivers. Preventive strategies, including health education, are essential to reduce incidence and recurrence. Objective The primary objective of this study was to evaluate the level of knowledge and awareness of nursemaid's elbow among parents and caregivers in Italy. The secondary objective was to promote preventive measures through educational interventions, particularly focusing on safe alternatives to risky practices such as lifting children by the wrists or performing the "vola-vola" game. Material and Methods A descriptive observational study was conducted in three phases: (1) a pilot study to validate the questionnaire, (2) administration of the definitive questionnaire via social platforms, and (3) dissemination of an educational video. The pilot questionnaire was tested on 100 participants to assess clarity, comprehensibility, and privacy compliance. The final questionnaire, consisting of 13 closed-ended items, was distributed between November 2024 and February 2025 to parents of children aged 0-5 years. Data were analyzed using IBM SPSS Statistics v31, applying binomial tests, Fisher's exact test, and internal consistency analysis. The educational video was shared on Facebook, Instagram, and LinkedIn, and its impact was measured through visualization metrics. Results The pilot study confirmed the validity of the questionnaire, with over 90% of participants rating it clear and comprehensible. In the main survey, 45.5% of parents reported lifting children by the wrists, and 74.8% admitted practicing the "vola-vola" game. Although 64.9% perceived the practice as potentially harmful, only 38.3% had received explicit advice against it. Knowledge of nursemaid's elbow was limited: 49.5% had heard of it, but fewer understood its causes (45.3%) or recognized its clinical signs (38.1%). Only 6.3% reported direct episodes in their children, with a high recurrence rate (94.9%). The educational video reached 5799 views, with Facebook accounting for the majority (3549), particularly among adults aged 25-44 years. Discussion The findings highlight a significant gap between risk perception and preventive communication. International literature confirms similar trends, with recurrence rates up to 14% and widespread lack of awareness. Imaging is generally unnecessary for diagnosis, except in atypical cases. Preventive education remains the cornerstone of reducing incidence. Conclusions Nursemaid's elbow continues to be a frequent condition in early childhood, exacerbated by insufficient parental knowledge. Educational campaigns targeting parents, teachers, and caregivers are crucial to promote safe practices and reduce recurrence. The dissemination of evidence-based information, particularly through social media, represents an effective strategy to improve awareness and safeguard pediatric health.