Comparison the Method of wrist Supination with Elbow Flexion as Classical Method with Hyperpronation Method in Reduction of Radial Head Subluxation in Less than 7 Years Old Children

The radial head subluxation is a common cause in less than 7 years old children who refered to emergency center after pulling of their wrist by parents. Compare the method of wrist supination with elbow flexion as classical method with hyperpronation method in reduction of radial head subluxation (pulled elbow) in children less than 7 years old referig to poorsina hospital during 2004-2009. In this randomized clinical trial, children who had referred to Poursina orthopedic emergency center with clinical diagnosis of radial head subluxation were studied consequent. Patients were randomly treated as consequent male and female with one of two methods. The patients were checked in order to diagnosis extremity functions return every 5 minutes. If extremity function had not returned, the primary method was repeated after 15 minutes. Unsuccessful treatment led to treatment with another method 30 minutes after first try. That method repeated if replacing method was not successful after 15 minutes. If both methods were unsuccessful, elbow radiography to roll-out other injury was performed. After collecting data, analysis was performed using chi- square test and T- test with SPSS software version 16. Among 110 patients were included in this study with average age (4.05±1.51 years) 58 patients (3.91±1.41 years) with first method (SF) and 52 patients (4.21±1.62 years) with second method were treated. (P=0.31) %62.7 of patients were male and the remaining were female (%37.3). In 47 patients (%90.4) of 52 patients who were treated by (HP) method. This was 46 patients (%79.3) from 58(P=0.11). Five patients of (HP) group needed second attempt where as this number were 12 about (F) group. Treatment with (HP) method was successful in 100 percent patients, but successful rate was %87.9 for (SP) method. There was significant superiority of (HP) success in comparison to (SF) (P+0/006). In reduction of radial head subluxation(HP) method was more successful upination method in reduction of radial head, it is more successful than supination, when supination was not successful than(SF) method.