Efficacy of Reduction Maneuvers For “Pulled Elbow” in Children

García-Mata, Serafín; Hidalgo-Ovejero, Ángel

doi:10.1097/bpo.0000000000000130

Cited by 19 publications

(17 citation statements)

References 15 publications

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“…Knee pain, the most common complaint at PPCC (17 %) [4], represented the fourth complaint in the ED, whereas other less common complaints, such as elbow or hip pain, were more frequent in younger children as previously reported [13,14,18,19].…”

Section: Discussionmentioning

confidence: 60%

Epidemiology of musculoskeletal pain in a pediatric emergency department

et al. 2015

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The objectives of this study were (1) to determine the percentage of emergency department (ED) visits due to musculoskeletal pain (MSP) by children 3-14 years of age during a period of 1 year; (2) to determine the most frequent presenting complaints; and (3) to characterize their etiology. A cross-sectional study was performed on children aged 3-14(11/12) years attended at the ED of a tertiary hospital due to MSP. The demographic and clinical characteristics of the patients were reviewed 5 days each month for 12 consecutive months. Study days were selected by computer-generated simple random sampling. Out of 4,531 visits to the ED, 826 were due to MSP (18.2 %; 95 % CI 17.1-19.4 %). When compared with children with no skeletal complaints, children with MSP had a similar sex distribution but were older (mean ± SD 7 ± 3.5 years vs 9.9 ± 3.1 years; p < 0.0001). The most common complaints were pain at the wrist (19 %), ankle (19 %) and finger (15 %). The most common etiology was trauma (88.4 %), including contusions (38 %), fractures (21 %) and sprains (18 %). Children with hip (6.7 ± 3 years; p < 0.0001) and elbow (7.8 ± 3.5 years; p < 0.0001) complaints were younger than children with pain in other locations, whereas children with wrist pain (10.5 ± 2.6 years; p < 0.002) and joint sprains (10.7 ± 2.7 years; p < 0.0001) were older. Fractures were more frequent in boys (64 vs 36 %, p = 0.008; OR 1.6; CI 1.1-2.2). Visits to the ED due to MSP increased with age. Pain at three locations represented 50 % of the presenting complaints. Trauma was the principal etiology, but fractures only represented one-fifth of the total.

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Section: Discussionmentioning

confidence: 60%

Epidemiology of musculoskeletal pain in a pediatric emergency department

et al. 2015

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“…In our study, 54.83% children were toddlers (1 to 3 years) and 22.58% preschooler (3 to 6 years) age group, this result is consistent to other studies. 6,7 this is because during this age children are at their most awkward and recalcitrant and do not obey to their parents, grandparents and seniors. 6 Whatever may be the mechanism, pulled elbow is basically caused by a traction injury where force is applied longitudinally to a pronated elbow 9 In this study 51.61% of patients complain of pain around forearm alone and 12.90% pointed pain around the wrist.…”

Section: Discussionmentioning

confidence: 99%

“…Because it is the standard reduction maneuver mentioned in the majority of publications. 7 we did not attempt another method known as Hyperpronation maneuver. In this study, 30 cases were successful in first attempt and only one case needed second attempt and was successful with this supination-flexion maneuver.…”

Section: Discussionmentioning

confidence: 99%

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Pulled elbow: A paediatrician's experience

Regmi

2017

J Chitwan Med Coll

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Pulled elbow is a common condition but may not be recognized by most of the paediatric physician. The purpose of this study is to evaluate the common age, mechanism, site of pain, reduction maneuver and its efficacy among paediatric population. Among 40 patients, 31 patients meeting the inclusion criteria were included in this study. Simple analytical method was used to analyze the data due to small number of patients. Supination-flexion maneuver was used for reduction. Among 31, 15 (48.38%) were male and 16(51.61%) were female. The mean age was 3.12 years, mean arrival time was 13.03 hours. 32.25% of patients had history of pulling the child up and 41.93% of patient complained of pain around forearm. All patient underwent supination- flexion maneuver and was successful in first attempt, except one, that required second attempt. There were no recurrences. There should be a high index of suspicion among paediatricians, so that they can correctly diagnose and treat this condition satisfactorily.

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“…По мнению D. Bek et al, оба метода патогенетически сходны, но в случае супинационно-флексионного метода, при котором предплечье из положения пронации переводят в супинацию, приходится преодолевать механическое сопротивление сместившейся связки, что вызывает затруднения и дополнительную боль [25]. Однако в других исследованиях сообщают о сопоставимой эффективности обоих методов репозиции, которая при первой попытке составила от 80,7 до 87,8 % [26,44,45].…”

Section: лечениеunclassified

Current views on radial head subluxation

Petrushin

Леонидович²,

Bragina

et al. 2020

Pediatr Traum Orthop Reconstr Surg

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Backgrоund. Radial head subluxation is the most common injury in young children and accounts for 2.6% of the total population in this age group. In 39%82% of cases, the mechanism of injury is the traction of the arm, but subluxation can occur during a fall and in other circumstances; in 19%51% of cases, the mechanism of injury is unknown. Aim. The purpose of this study is to generalize and arrange the available literature and data and present current views on the prevalence, etiology, pathogenesis, diagnosis, and treatment of radial head subluxation in children. Materials and methods. A literature search was performed using the PubMed, PubMed Central, Google Scholar, CNKI-Scholar, Cyberleninka, and eLibrary databases. The sample of sources was mainly limited to 20002019. Results. The cause of subluxation is the displacement of the annular ligament and its interposition in the humeroradial joint. It is determined by a number of features of the elbow joint anatomy in young children. Diagnosis of radial head subluxation is based on history and clinical data; radiography and ultrasonography are used to obtain a clear clinical picture and to exclude fractures. The mainstay of treatment is a closed reduction, which is conducted via two methods as follows: supinationflexion and hyperpronation. According to modern research data, preference is given to the hyperpronation method; it is more effective in terms of number of reduction attempts, is technically simpler and, possibly, less painful. Generally, immobilization after effective reduction is not required as the function of the elbow joint is fully restored. A consequence of radial head subluxation is recurrence, which occurs in 5%46% of cases. A factor associated with recurrence is being less than two years of age. The prophylaxis of radial head subluxation is aimed at preventing forceful arm traction in children under three years of age and involves educating the parents or caregivers in the symptoms of subluxation to prevent late admission. Conclusions. Radial head subluxation is found in young children and is mainly diagnosed clinically. The treatment consists of a closed reposition, and the prognosis for restoring limb function is favorable.

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Efficacy of Reduction Maneuvers For “Pulled Elbow” in Children

Cited by 19 publications

References 15 publications

Epidemiology of musculoskeletal pain in a pediatric emergency department

Epidemiology of musculoskeletal pain in a pediatric emergency department

Pulled elbow: A paediatrician's experience

Current views on radial head subluxation

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