The Elbow

Manipulation

Reduction is easy. Sometimes spontaneous reduction occurs during passive examination of the elbow.

When this does not happen, manipulation is performed as follows:

Technique:

The child lies supine with the arm slightly abducted and the elbow flexed to a right angle.
One hand stabilizes the upper arm against the couch.
The other hand grasps the lower forearm and presses the radius downwards against the couch.
The manipulator then rapidly rotates the forearm to and fro to the end of range in either direction.
Suddenly, on full supination, the radial head reduces with a palpable click whereupon the elbow movements become normal and painless.