S2E41 - Reducing Pulled Elbows in Clinical Exams

Welcome to Season 2 of AMC Clinical Deep Dive!

Common in children aged 1–4, this subluxation of the radial head is a high-yield OSCE scenario. This episode breaks down the NHMRC Level 1 evidence favouring the pronation manoeuvre—proven to be more effective and less painful than traditional supination. Learn to identify the classic presentation (elbow in extension, forearm in pronation, and no swelling) and master the stepwise reduction: attempt pronation twice before switching to supination. We cover critical safety checks to rule out fractures and the essential parental warning regarding recurrence risks. Transform a distressed toddler into a happy, active child in just 5 minutes with this evidence-based guide!

#AMCClinicalExam #PulledElbow #Nursemaid’sElbow #RadialHeadSubluxation #PronationManoeuvre #OSCE #IMGAustralia #PediatricEmergency

Pro Tip: In your OSCE, always start with the pronation manoeuvre rather than supination. Explicitly mention that you are following NHMRC Level 1 evidence and tell the examiner you will review the child in 10 minutes. Don't forget the "Safety Net": warn the parents that the injury is common and has a high risk of recurring within a month. This shows you are a safe and clinically informed practitioner!

Also, listen to: S1E61 - The Girl with the Fractured Elbow

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