Sir.—Most cases of RHS should never reach the emergency room. The history is so typical and the treatment so simple that over half of these cases can be well managed by a telephone conversation. Most parents can follow the simple supination maneuver and feel the click. Children with RHS only need to be seen if the history is not typical, if the parent is not able to follow the instructions, or if the child does not resume use of the arm soon.
If the child is seen, the caretaker should certainly be instructed in the reduction method. Let us aim to keep all subluxed elbows out of the expensive emergency room where so often unneeded roentgenography is performed. Of course, seeing these children in the office is an easy way to be the hero since the cure is dramatic.