What is the initial reduction maneuver for nursemaid's elbow in a child presenting with sudden elbow pain?

What is the initial reduction maneuver for nursemaid's elbow in a child presenting with sudden elbow pain?

• A. Pronation with extension
• B. Immobilize without reduction
• C. Supination with flexion
• D. Instruct to wait and see

Answer: (C)

When a child has nursemaid’s elbow, the goal is to realign the radial head by repositioning the forearm so the radius can slip back under the annular ligament. Supination of the forearm followed by flexion of the elbow is the classic move because this sequence directly reorients the radius into its normal position and often allows a quick return to full motion with minimal discomfort. The maneuver is favored for its high success rate and rapid relief of pain, making it the initial reduction technique most clinicians teach. Options that involve immobilizing without attempting reduction or telling the child to wait do not address the displaced structure and would delay healing. An alternative technique exists (a different forearm rotation method), but supination with flexion remains the standard first choice for reduction.

When a child has nursemaid’s elbow, the goal is to realign the radial head by repositioning the forearm so the radius can slip back under the annular ligament. Supination of the forearm followed by flexion of the elbow is the classic move because this sequence directly reorients the radius into its normal position and often allows a quick return to full motion with minimal discomfort. The maneuver is favored for its high success rate and rapid relief of pain, making it the initial reduction technique most clinicians teach. Options that involve immobilizing without attempting reduction or telling the child to wait do not address the displaced structure and would delay healing. An alternative technique exists (a different forearm rotation method), but supination with flexion remains the standard first choice for reduction.