Do Reduction Maneuvers Affect Recurrence in Pediatric Radial Head Subluxation? A Ten-Year Retrospective Analysis

Area of Science:

• Pediatric Emergency Medicine
• Orthopedics
• Radiology

Background:

• Nursemaid's elbow, or radial head subluxation, is a common pediatric injury.
• The choice of reduction maneuver is debated regarding recurrence rates.
• Understanding epidemiological factors is essential for clinical practice.

Purpose of the Study:

• To investigate the influence of different reduction maneuvers on the recurrence of nursemaid's elbow.
• To describe the epidemiological characteristics of nursemaid's elbow in emergency department patients.

Main Methods:

• Retrospective analysis of 1359 pediatric patients diagnosed with nursemaid's elbow.
• Data collected included demographics, affected side, reduction technique, and recurrence.
• Statistical analysis using the chi-square test (p < 0.05 significance).

Main Results:

• The median patient age was 2 years, with 61.2% females; 88.1% were aged 0-3 years.
• Left elbow involvement (63.0%) was more common than right (37.0%).
• Recurrence rate was 4.8%, significantly higher with right elbow involvement and the supination-flexion maneuver (p < 0.05).

Conclusions:

• Nursemaid's elbow predominantly affects children under three, particularly girls, and the left arm.
• The hyperpronation maneuver demonstrated a lower recurrence rate compared to supination-flexion.
• This suggests hyperpronation may be a preferred reduction technique to minimize recurrent dislocations.