Enrico Volpe
Painful pronation of the radius, commonly known as nursemaid’s elbow, is one of the most frequent causes of acute elbow pain in preschool children and typically results from a sudden traction of the upper limb. The article reviews the main anatomical, clinical and therapeutic aspects of this condition, with particular focus on the injury mechanism and reduction techniques. Current evidence indicates that the diagnosis is primarily clinical and based on the patient’s history and physical examination, while radiological investigations are recommended only in selected cases to exclude alternative traumatic injuries. The commonly used reduction manoeuvres, namely the supination–flexion technique and hyperpronation, are generally effective and allow a rapid resolution of symptoms. Therefore, early recognition of painful pronation enables prompt and straightforward clinical management. In addition, appropriate parental education on safe child-handling practices plays an important role in preventing recurrence.