Hyperpronation has greater first attempt success (94% vs 69%), but both have similar overall reduction rate; consider doing both techniques at once in quick succession
Hyperpronation Technique
Hold patient's<unk>  at 90 degrees with one hand
Place thumb over radial head to facilitate reduction and provide tactile feedback
With other hand hyperpronate patient's wrist
Supination Technique
Hold patient's<unk>  at 90 degrees with one hand
Place thumb over radial head to facilitate reduction and provide tactile feedback
With other hand supinate patient's wrist and fully flex<unk> 
Hold patient's<unk>  at 90 degrees with one hand
Place thumb over radial head to facilitate reduction and provide tactile feedback
With other hand hyperpronate patient's wrist
Place thumb over radial head to facilitate reduction and provide tactile feedback
Hold patient's<unk>  at 90 degrees with one hand
Place thumb over radial head to facilitate reduction and provide tactile feedback
With other hand supinate patient's wrist and fully flex<unk> 
Place thumb over radial head to facilitate reduction and provide tactile feedback
If successful, patient will have return of full range of motion within 30min
Usually child with begin to spontaneously use the affected arm
If child is not using affected arm, may try offering a popsicle or toy and encouraging to reach with affected arm
If unsuccessful after multiple attempts, obtain x-ray and consider alternative diagnoses (e.g. Salter-Harris fracture)
Usually child with begin to spontaneously use the affected arm
If child is not using affected arm, may try offering a popsicle or toy and encouraging to reach with affected arm
Nursemaid's elbow
Distal humerus fracture
Drummer's wrist
Radial head fracture
Trench foot
Essex-Lopresti fracture
Boutonniere deformity
Capitellum fracture