Radial Head Subluxation (Nursemaid's Elbow):

• Age Range: 6 months to 7 years old (usually 2-3 years old)
• Mechanism: Sudden, longitudinal traction on arm with elbow extended
• Annular ligament of radius displaces into radiocapitellar articluation
• Two Reduction Techniques: Supination Technique and Hyperpronation Technique

Supination Technique:

• Hold childs elbow at 90 degrees with one hand
• Supinate the patient's extremity at the wrist
• Flex the supinated wrist towards the patient's shoulder
• Feel for reduction of radial head with hand on elbow.

Hyperpronation Technique:

• Hold patient's elbow at 90 degrees
• Firmly pronate at wrist until reduction is complete
• Consider investingating for occult fractures if patient does not resume normal use of extremity within 30 minutes after reduction.

References:
1) Hopkins-Mann C, Ogunnaike-Joseph D, Moro-Sutherland D. Chapter 143C. Pediatric Procedures: Nursemaids' Elbow Reduction. In: Tintinalli JE, Stapczynski J, Ma O, Cline DM, Cydulka RK, Meckler GD, T. eds. Tintinalli's Emergency Medicine: A Comprehensive Study Guide, 7e. New York, NY: McGraw-Hill; 2011. http://accessmedicine.mhmedical.com/content.aspx?bookid=348&Sectionid=40....