From the Research
Nursemaid's elbow, also known as radial head subluxation, is the condition you're describing where a child's elbow can be easily snapped back into place, and the most effective reduction technique is hyperpronation, as shown in a systematic review and meta-analysis 1. This common childhood injury typically occurs in children under 5 years old when sudden pulling on the arm causes the radial head to slip partially out of its ligament. The reduction technique involves hyperpronation of the forearm, which has been shown to be more effective than supination-flexion, with a success rate of 74% compared to 48% for supination-flexion 1. Some key points to consider are:
- The condition usually occurs in children 1-4 years of age and typically results from a pulling mechanism on an outstretched arm 2.
- Parents should seek medical attention for proper diagnosis and treatment rather than attempting reduction at home, as improper technique could worsen the injury.
- After reduction, the child typically regains normal arm function within minutes.
- To prevent recurrence, avoid lifting or pulling children by their hands or wrists; instead, lift under the armpits, as certain mechanisms such as lifting the child by the arms, "wrestling", swinging child by the arms, and placing the child into and out of a seat are potentially preventable 3. The condition usually resolves permanently as children grow and their ligaments strengthen, though some children may experience repeated episodes until around age 5-7. Recent studies have reviewed the causes, evaluation, and management of radial head subluxation, providing a comprehensive understanding of the condition 4.