There are two ways to treat a Nursemaid’s elbow (radial head subluxation) – supination/flexion or hyperpronation. I’ve done both. I’m a fan of hyperpronation, so, therefore, I’m highlighting a study that agrees with my practice pattern.
This systematic review covers 7 studies enrolling 701 patients, comparing the success rate and perceived pain of each technique. Trials were, generally and for some obvious reasons, limited in terms of blinding and outcome assessment. Pooled failure rate with hyperpronation 9.1% was while failure with supination /flexion was 27.3%. In studies reporting pain scores, subjective external rating of child pain during procedure also favored the hyperpronation group.
Use it!
This video demonstrates both techniques, although I’ve seen variations on hyperpronation both using extension and flexion.
“Effectiveness of reduction maneuvers in the treatment of nursemaid’s elbow: A systematic review and meta-analysis”
https://www.ncbi.nlm.nih.gov/pubmed/27836316