OBJECTIVES: The purpose of this study was to compare the efficiency of the hyperpronation and supination-flexion maneuvers in the reduction of the pulled elbow. METHODS:Sixty-six patients with pulled elbow were randomized for reduction with either hyperpronation or supination-flexion maneuvers. When the first attempt failed, a second attempt was performed with the same reduction maneuver. After failure of the second attempt the reduction maneuver was changed to the alternate method. The success rate of the reductions and the subjective rating on the difficulty of the reduction by the physician were recorded and analyzed statistically. RESULTS: Thirty-two of 34 patients (94%) in the hyperpronation group and 22 of 32 patients (69%) in the supination-flexion group were reduced at first attempt (P=0.007). Two patients in the hyperpronation group and seven patients in the supination-flexion group were reduced at the second attempt. Reduction rates were statistically similar (P=0.06). Three patients in the supination-flexion group had failed reduction at the second attempt and the reduction maneuver needed to be changed. They were successfully reduced with hyperpronation maneuver at the first attempt. Final success rate of the hyperpronation maneuver at the first attempt was statistically higher than the supination-flexion maneuver (P=0.004). Furthermore, the hyperpronation maneuver was rated significantly easier than the supination-flexion maneuver by physicians (P=0.003). CONCLUSION: Although final reduction rates were similar, the hyperpronation maneuver was more efficient at the first attempt, easier for physicians and less painful for the children.
RCT Entities:
OBJECTIVES: The purpose of this study was to compare the efficiency of the hyperpronation and supination-flexion maneuvers in the reduction of the pulled elbow. METHODS: Sixty-six patients with pulled elbow were randomized for reduction with either hyperpronation or supination-flexion maneuvers. When the first attempt failed, a second attempt was performed with the same reduction maneuver. After failure of the second attempt the reduction maneuver was changed to the alternate method. The success rate of the reductions and the subjective rating on the difficulty of the reduction by the physician were recorded and analyzed statistically. RESULTS: Thirty-two of 34 patients (94%) in the hyperpronation group and 22 of 32 patients (69%) in the supination-flexion group were reduced at first attempt (P=0.007). Two patients in the hyperpronation group and seven patients in the supination-flexion group were reduced at the second attempt. Reduction rates were statistically similar (P=0.06). Three patients in the supination-flexion group had failed reduction at the second attempt and the reduction maneuver needed to be changed. They were successfully reduced with hyperpronation maneuver at the first attempt. Final success rate of the hyperpronation maneuver at the first attempt was statistically higher than the supination-flexion maneuver (P=0.004). Furthermore, the hyperpronation maneuver was rated significantly easier than the supination-flexion maneuver by physicians (P=0.003). CONCLUSION: Although final reduction rates were similar, the hyperpronation maneuver was more efficient at the first attempt, easier for physicians and less painful for the children.
Authors: Marjolein Krul; Johannes C van der Wouden; Emma J Kruithof; Lisette Wa van Suijlekom-Smit; Bart W Koes Journal: Cochrane Database Syst Rev Date: 2017-07-28
Authors: Alexandru Ulici; Alexandru Herdea; Madalina Carp; Catalin Alexandru Nahoi; Iulia Tevanov Journal: Indian J Orthop Date: 2019 Jan-Feb Impact factor: 1.251
Authors: Jack J Zhou; Neil V Shah; Ryan C Scheer; Jared M Newman; Omar K Hariri; Mikhail Tretiakov; Steven M Koehler; Khalid Hesham; William R Aibinder; Christopher R Chapman Journal: Eur J Orthop Surg Traumatol Date: 2021-08-07