Efficacy of reduction maneuvers for 'pulled elbow' in children: a prospective study of 115 cases
| Autor: | Angel M. Hidalgo-Ovejero, Serafín García-Mata |
|---|---|
| Rok vydání: | 2013 |
| Předmět: |
Male
medicine.medical_specialty medicine.medical_treatment Elbow Supination Group B Immobilization Recurrence medicine Humans Orthopedics and Sports Medicine Pronation Prospective Studies Treatment Failure Range of Motion Articular Prospective cohort study Child Reduction (orthopedic surgery) Relative efficacy business.industry Infant Mean age General Medicine Bone Malalignment Surgery Casts Surgical Radius medicine.anatomical_structure Treatment Outcome Child Preschool Pediatrics Perinatology and Child Health Manipulation Orthopedic Female business Elbow Injuries |
| Zdroj: | Journal of pediatric orthopedics. 34(4) |
| ISSN: | 1539-2570 |
| Popis: | BACKGROUND The objective of our study is to determine the relative efficacy of the 2 reduction maneuvers, hyperpronation (HP) and supination-flexion (SF), in pulled elbow (PE). METHODS We conducted a randomized, prospective study of 2 reduction maneuvers in 115 patients with PE and a mean age of 2 years and 3 months. Patients were randomly divided into 2 groups: group A, with 65 children (56.52%) who underwent HP; and group B, with 50 children (43.47%) who underwent SF. RESULTS In 97.39% of the children, reduction was achieved by manipulation. Reduction was achieved at first attempt (using either maneuver) in 101 of 115 patients (87.82%), with 93.84% success for HP and 80% for SF (P=0.0243). Most patients in whom our first attempts failed (85.71%) had undergone prior manipulation: 100% of treatment failures from group A; and 80% of failures from group B. Most (95.04%) patients in whom our first attempts succeeded had not undergone prior manipulation: 93.44% from group A; and 97.5% from group B. A significant relationship was found when comparing those who had undergone prior manipulation from group A (P=0.0001) and group B (P=0.000000072). CONCLUSIONS Although both SF and HP are effective for reduction of PE, a higher first-attempt success rate was achieved by HP, and this should therefore be the first maneuver used. In recurring cases, it would seem appropriate to teach the child's parents the HP maneuver as the most effective and easiest to do. |
| Databáze: | OpenAIRE |
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