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Related Experiment Video

Updated: May 25, 2026

A Standardized Method for Measurement of Elbow Kinesthesia
07:56

A Standardized Method for Measurement of Elbow Kinesthesia

Published on: October 10, 2020

Manipulative interventions for reducing pulled elbow in young children.

Marjolein Krul1, Johannes C van der Wouden, Lisette W A van Suijlekom-Smit

  • 1Department of General Practice, ErasmusMedical Center, Rotterdam, Netherlands. m.krul@erasmusmc.nl.

The Cochrane Database of Systematic Reviews
|January 20, 2012
PubMed
Summary

Pronation may be a more effective and less painful method for treating pulled elbow (nursemaid

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Area of Science:

  • Pediatrics
  • Orthopedics
  • Musculoskeletal Disorders

Background:

  • Pulled elbow (nursemaid's elbow) is a common pediatric injury caused by a sudden pull on the arm.
  • This injury results in subluxation of the radial head, leading to acute pain and arm dysfunction.
  • Current treatment involves manual reduction, with supination often recommended, but effectiveness is unclear.

Purpose of the Study:

  • To compare the effectiveness and painfulness of different manipulative techniques for treating pulled elbow in young children.
  • To update a previous Cochrane review on this topic.

Main Methods:

  • Systematic review and meta-analysis of randomized and quasi-randomized controlled trials.
  • Searched multiple databases including Cochrane, MEDLINE, EMBASE, and CINAHL up to July 2011.

Related Experiment Videos

Last Updated: May 25, 2026

A Standardized Method for Measurement of Elbow Kinesthesia
07:56

A Standardized Method for Measurement of Elbow Kinesthesia

Published on: October 10, 2020

  • Included four trials involving 379 children under seven years old, comparing pronation and supination techniques.

    • Main Results:

    • Pronation demonstrated statistically significantly lower failure rates compared to supination (RR 0.45; 95% CI 0.28 to 0.73).
    • Two trials reported pain perception, with both concluding that the pronation technique was less painful.
    • All included trials had a high risk of bias, particularly in selection and detection.

    Conclusions:

    • Limited evidence from low-quality trials suggests pronation may be more effective and less painful than supination for pulled elbow reduction.
    • A high-quality randomized controlled trial is recommended to strengthen the evidence base.
    • Further research is needed to definitively establish the optimal manipulation technique.