Reduction by "puller" techniques in a supine position.
(A) With the elbow flexed to almost 90 degrees, a force is applied to the anterior portion of the forearm with one hand while the other hand pulls distally along the forearm. A counterforce is applied to offset the manipulating forces by direct stabilization of the patient by a second medical person.
(B) The counterforce is applied with a sheet around the chest in the ipsilateral axilla.
Reproduced with permission from: Stans AA, Lawrence JTR. Dislocations of the elbows, medial epicondylar humerus fractures. In: Rockwood and Wilkins' Fractures in Children, 8th ed, Flynn JM, Skaggs DL, Waters PM (Eds), Wolters Kluwer, Philadelphia 2015. Copyright © 2015 Lippincott Williams & Wilkins.
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