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Nursemaid’s Elbow – Supination-flexion Technique Versus Hyperpronation/forced Pronation: Randomized Clinical Study

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Abstract

Background

Nursemaid’s elbow (NE) represents the most common pathology met in the pediatric orthopedics ambulatory. There are two techniques of reducing the NE: the supination-flexion technique and the hyperpronation or forced pronation technique.

Materials and Methods

In this randomized clinical study, we aim to compare the two reduction techniques of the NE, by measuring the effectiveness of each and scaling the pain felt by the child, by using the Faces Pain Scale. The study included 116 patients with typical presentation for NE with age under 7 years old (mean age ~3 years old), 45% of males and 55% of females.

Results

Hyperpronation was found to be more successful than supination-flexion technique as a first attempt (85% vs. 53%), second attempt (50% vs. 28%), and as a crossover technique (100% vs. 50%) when supination-flexion failed.

Conclusions

This study concludes that hyperpronation technique should be used as a first maneuver reduction in treating NE, a simple one-movement technique.

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Authors and Affiliations

  1. Department of Pediatric Orthopedic Surgery, Emergency Hospital for Children “Grigore Alexandrescu”, Bucharest, Romania

    Alexandru Ulici,  Alexandru Herdea, Madalina Carp, Catalin Alexandru Nahoi & Iulia Tevanov

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  1. Alexandru Ulici
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  2. Alexandru Herdea
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  3. Madalina Carp
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  4. Catalin Alexandru Nahoi
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  5. Iulia Tevanov
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Correspondence to Alexandru Herdea.

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Ulici, A., Herdea, A., Carp, M. et al. Nursemaid’s Elbow – Supination-flexion Technique Versus Hyperpronation/forced Pronation: Randomized Clinical Study. JOIO 53, 117–121 (2019). https://doi.org/10.4103/ortho.IJOrtho_442_17

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  • DOI: https://doi.org/10.4103/ortho.IJOrtho_442_17

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