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Reduction of pulled elbows
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  • Published on:
    A pulled elbow needs pushing back

    Dear Editor

    It is not surprising that pronation is better than supination to reduce a pulled elbow.[1] The principle of any reduction is to apply force in the opposite direction to the causal force.

    When a toddler is pulled up by the arm it usually swings inwards, causing a traction/supination force that can sublux the radial head. But whichever way the arm was twisted it was also pulled, and the radial...

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    Conflict of Interest:
    None declared.
  • Published on:
    Pronation is overwhelmingly superior to supination
    • David Alao, Specialist registrar accident and emergency medicine

    Dear Editor

    I read with interest the Best bet on the reduction of pulled elbow by David Lewis in Emergency Medical Journal January 2003.[1]

    While I agree with the author’s conclusion he failed to state the fact that pronation technique was overwhelmingly superior to supination technique on second attempt (p=0.009).[2] In addition on the third attempt when the two techniques were crossed over, pronation tec...

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    Conflict of Interest:
    None declared.