Suggestion of a Modified Reduction Maneuvers with Parents in the Pulled Elbow Children

ABSTRACT

PURPOSE: If radial head subluxation, otherwise known as pulled elbow, occurs, closed reduction can be used in simultaneous diagnosis and treatment of the child. As the guardian seldom understands the maneuver without explanation, we revised a method to involve the caregiver in the treatment. METHODS: This was a prospective controlled study. From January, 2014 to December, 2014, children suspected of radial head subluxation, under the age of 6, were enrolled. Patients were randomly assigned to two groups. One group was treated conventionally and the other group was treated while the parent's finger was on the patient's lateral epicondyle. A total of three attempts were made using the hyperpronation method and the supination-flexion method. The physician then recorded whether the treatment was successful, the number of attempts, easiness of the reduction, and guardian's degree of understanding and satisfaction. RESULTS: A total of 116 patients were enrolled. The number of attempts was 1.27 and 1.35 times in the experimental group and the control group, respectively. The success rate was 96.6% in the experimental group and 94.7% in the control group. There was no statistically significant difference within the two groups. The physicians found that the revised method was as easy as the conventional method and the caregiver's degree of understanding was higher in the experimental group. CONCLUSION: As the revised method increases the degree of guardians' understanding and does not increase the difficulty of the procedure, we recommend using the revised method in treatment of radial head subluxation.