A one and a half year old child holding her father’s hand slipped and fell but did not let go of her father’s hand. After that she continued to cry and hold the forearm in pronated position and refused to move the affected extremity. Which of the following management at this stage is most appropriate?

**Core Concept**
The scenario describes a classic presentation of a toddler's fracture, also known as a **nursemaid's elbow** or **radial head subluxation**. This condition occurs when the radius bone in the forearm is partially dislocated from the elbow joint. It is a common injury in young children due to the anatomy of their elbow joint and the mechanism of injury, often from a fall or sudden pull on the extended arm.

**Why the Correct Answer is Right**
Given the clinical presentation, the most appropriate management at this stage would involve reducing the subluxation to alleviate pain and restore normal movement. This can typically be achieved through a simple maneuver, such as **supination and flexion of the forearm**, which helps to relocate the radial head into its normal position.

**Why Each Wrong Option is Incorrect**
**Option A:** Incorrect because it does not specify a method for immediate reduction of the subluxation.
**Option B:** Incorrect as it might not be immediately necessary without first attempting reduction.
**Option C:** Incorrect because immobilization alone does not address the need for reduction of the subluxation.

**Clinical Pearl / High-Yield Fact**
A key point to remember is that **nursemaid's elbow** can often be managed with a simple reduction maneuver, and the child usually experiences immediate relief from pain and resumes normal activity.

**Correct Answer:** D. Reduction of subluxation by supination and flexion of the forearm.

✓ Correct Answer: A. Supinate the forearm