What is the definitive treatment for a patient diagnosed with nursemaid's elbow?

• A. Open reduction and internal fixation
• B. Closed reduction
• C. Arm sling
• D. External fixation

Answer: (B)

The definitive treatment for a patient diagnosed with nursemaid's elbow, also known as radial head subluxation, is closed reduction. This condition commonly occurs in young children when a sudden pull on the arm causes the radial head to slip out of its normal position in the elbow joint.

Closed reduction involves a specific maneuver that typically can be performed in a clinical setting. The clinician applies pressure to the radial head while simultaneously flexing and supinating the forearm, which often successfully relocates the radial head back into the annular ligament. This procedure is generally quick, requires minimal resources, and does not involve any surgical intervention.

Since nursemaid's elbow is a common and non-surgical injury, other treatment options such as surgical interventions (open reduction and internal fixation or external fixation) are not indicated and are reserved for more complex fractures or dislocations requiring stabilization. Additionally, an arm sling may provide temporary comfort to the patient but does not address the underlying dislocation or reduce it back into place, making it an inadequate treatment for this specific condition.

Thus, closed reduction stands out as the most effective and appropriate method for managing nursemaid's elbow.