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A 3-year-old male has decreased use of his left elbow after his mother grabbed his arm and attempted to lead him across the street. Physical exam demonstrates guarding of the extremity with a slightly flexed and pronated arm, elbow swelling, and focal tenderness. A lateral radiograph is shown in Figure A. What is the most appropriate first step in management?
Aspiration of the elbow joint with blood cultures
Closed reduction via supination and flexion
Closed reduction via longitudinal traction
Placement into long arm splint with no reduction required
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A 2-year-old is brought to the emergency room with reports of acute elbow pain and limited use of the left upper extremity. The patient is neurovascularly intact and is afebrile. Examination reveals that the elbow is in slight flexion and the forearm pronated but further examination is limited secondary to pain. AP and lateral radiographs are shown in Figures A and B. What is the next best step in management?
Supination and flexion reduction maneuver
Supination reduction maneuver with long arm casting
Closed reduction and percutaneous pinning