| Pronation versus supination maneuvers for the reduction of 'pulled elbow': a randomized clinical trial. | |
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MedLine Citation:
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PMID: 19262394 Owner: NLM Status: MEDLINE |
Abstract/OtherAbstract:
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OBJECTIVES: The purpose of this study was to compare the efficiency of the hyperpronation and supination-flexion maneuvers in the reduction of the pulled elbow. METHODS: Sixty-six patients with pulled elbow were randomized for reduction with either hyperpronation or supination-flexion maneuvers. When the first attempt failed, a second attempt was performed with the same reduction maneuver. After failure of the second attempt the reduction maneuver was changed to the alternate method. The success rate of the reductions and the subjective rating on the difficulty of the reduction by the physician were recorded and analyzed statistically. RESULTS: Thirty-two of 34 patients (94%) in the hyperpronation group and 22 of 32 patients (69%) in the supination-flexion group were reduced at first attempt (P=0.007). Two patients in the hyperpronation group and seven patients in the supination-flexion group were reduced at the second attempt. Reduction rates were statistically similar (P=0.06). Three patients in the supination-flexion group had failed reduction at the second attempt and the reduction maneuver needed to be changed. They were successfully reduced with hyperpronation maneuver at the first attempt. Final success rate of the hyperpronation maneuver at the first attempt was statistically higher than the supination-flexion maneuver (P=0.004). Furthermore, the hyperpronation maneuver was rated significantly easier than the supination-flexion maneuver by physicians (P=0.003). CONCLUSION: Although final reduction rates were similar, the hyperpronation maneuver was more efficient at the first attempt, easier for physicians and less painful for the children. |
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Authors:
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Doğan Bek; Cemil Yildiz; Ozkan Köse; Ali Sehirlioğlu; Mustafa Başbozkurt |
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Publication Detail:
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Type: Journal Article; Randomized Controlled Trial |
Journal Detail:
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Title: European journal of emergency medicine : official journal of the European Society for Emergency Medicine Volume: 16 ISSN: 1473-5695 ISO Abbreviation: Eur J Emerg Med Publication Date: 2009 Jun |
Date Detail:
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Created Date: 2009-05-06 Completed Date: 2009-08-04 Revised Date: - |
Medline Journal Info:
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Nlm Unique ID: 9442482 Medline TA: Eur J Emerg Med Country: England |
Other Details:
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Languages: eng Pagination: 135-8 Citation Subset: IM |
Affiliation:
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Department of Orthopedics and Traumatology, Gülhane Military Medical Academy, Ankara, Turkey. |
Export Citation:
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| MeSH Terms | |
Descriptor/Qualifier:
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Child, Preschool Dislocations / therapy* Elbow Joint / injuries* Female Humans Male Manipulation, Orthopedic / methods* Pain / prevention & control Pronation* Prospective Studies Supination* |
From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine
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