Pulled elbow is a common injury in young children. Reduction of a pulled elbow is
a simple and benign intervention that can be performed in an outpatient setting
with rapid results. Some studies have shown that the hyperpronation method is
more effective than supination and may be less painful.Clinicians should be
competent in treating this common pediatric injury.
Figure 1. The Annular Ligament.The neck of the radius is encircled by the annular ligament, which holds the radius tightly in place against the ulna.
Figure 2. Entrapment of the Annular Ligament. With forceful longitudinal traction, the radial head is pulled underneath the annular ligament.
Figure 3. Positioning for the Supination Technique.
Figure 4. Flexion and Supination of the Hand and Arm in the Supination Technique.
Figure 5. Clasping of the Patient’s Hand in the Hyperpronation Technique.
Figure 6. Hyperpronation of the Patient’s Wrist during Reduction of a Pulled Elbow.