Comparison of Supination-Flexion and Hyperpronation Maneuvers for Reducing Radial Head Subluxation .
Comparison of supination/flexion maneuver to hyperpronation maneuver in the reduction of radial head subluxations: A randomized clinical trial.
Am J Emerg Med. 2025 Feb:88:29-33.One hundred nineteen (119) children ≤6 years old with radial head subluxation were randomized to receive either the supination-flexion (SF) maneuver (n=58) or the hyperpronation (HP) maneuver (n=61). The primary outcome of interest was first-attempt treatment failure. Secondary outcomes included second-attempt failure, ultimate failure (after three attempts), recurrence within 72 hours, pain during reduction, and adverse events. Overall, the study revealed a significantly lower first-attempt failure rate with HP (9.8%) compared to SF (24.2%), with no significant differences in secondary outcomes. This suggests that HP should be the preferred initial maneuver for children with RHS.
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