Sign up to save your podcasts
Or
Share Which technique is best for reducing a pulled elbow?
Share to email
Share to Facebook
Share to X
Share to email
Share to Facebook
Share to X
Or
Which technique is best for reducing a pulled elbow?
Background
The triage nurse comes to tell you that s/he has a toddler with a pulled elbow in triage. You want to reduce it straightaway and send the child home, high-fiving the whole family on their way out. You wonder which reduction technique is most likely to be successful...
Pulled elbow is a painful condition of acute onset, resulting in sudden loss of function in the affected limb of a child[1]. The mechanism of injury is often a sudden pull on the ipsilateral hand/forearm (e.g. parent pulling the child up a kerb[2], or even the child pulling its hand away impulsively), resulting in subluxation of the radial head. Pulled elbow can also be caused by a fall[3] or twist. Typically, the child will suddenly cry out in pain and then refuse to use their arm. A snap or click may be heard[4]. The arm is held slightly flexed and twisted inwards[5], without any bruising or swelling. Pain may be felt at the shoulder or wrist as well as the elbow[5,6].
Two main reduction techniques are described: supination-flexion (the traditional method) and hyperpronation.
Krul M, van der Wouden JC, Kruithof EJ, van Suijlekom-Smit LWA, Koes BW. Manipulative interventions for reducing pulled elbow in young children. Cochrane Database of Systematic Reviews 2017, Issue 7[7]
For detailed show notes please visit our website: https://the-breach.com
View all episodes
By Barrie StevensonBackground
The triage nurse comes to tell you that s/he has a toddler with a pulled elbow in triage. You want to reduce it straightaway and send the child home, high-fiving the whole family on their way out. You wonder which reduction technique is most likely to be successful...
Pulled elbow is a painful condition of acute onset, resulting in sudden loss of function in the affected limb of a child[1]. The mechanism of injury is often a sudden pull on the ipsilateral hand/forearm (e.g. parent pulling the child up a kerb[2], or even the child pulling its hand away impulsively), resulting in subluxation of the radial head. Pulled elbow can also be caused by a fall[3] or twist. Typically, the child will suddenly cry out in pain and then refuse to use their arm. A snap or click may be heard[4]. The arm is held slightly flexed and twisted inwards[5], without any bruising or swelling. Pain may be felt at the shoulder or wrist as well as the elbow[5,6].
Two main reduction techniques are described: supination-flexion (the traditional method) and hyperpronation.
Krul M, van der Wouden JC, Kruithof EJ, van Suijlekom-Smit LWA, Koes BW. Manipulative interventions for reducing pulled elbow in young children. Cochrane Database of Systematic Reviews 2017, Issue 7[7]
For detailed show notes please visit our website: https://the-breach.com