Elbow Orthopedics
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þ Dislocation:
 - "arm-wrestling" technique:
   grab the patient's hand, put your elbow on top of theirs, pull up. 
   
þ Nursemaid's elbow:
 - try hyper-pronation to reduce, move slowly
   Two RCTs showed hyper-pronation with better success rates
   
   [Macias, Pediatrics, 19984 Prospective, randomized, 90 kids 
   under 6 years of age Supination/flexion vs Hyperpronation, 
   repeat after 15 minutes Crossover if unsuccessful x2, 
   radiographs if both failed Pronation better (95% vs 77% 
   successful first attempt) Of 6 crossovers from supination, 5 
   reduced by pronation 
   McDonald, Academic Emergency Medicine, 
   19995 Prospective, randomized, 135 patients Supination/flexion 
   vs Pronation/flexion Pronation better (80% vs 69% successful 
   first attempt) Physicians rated less pain with pronation]                                  

þ Radiocapitellar line: 
 - center of radius goes to center of capitellum, 
 = maintained in nursemaid's elbow

þ Anterior Humeral line: cuts off anterior 1/3 of capitellum on lateral view

þ Supinator Fat Stripe: 
 - helps with radial head fracture

þ Capitellum: 
 - ossifies year 1