Executive Editor: Peter Trafton

Authors: Raymond White, Matthew Camuso

Tibial shaft

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Lateral position
Lateral position enlarge

Patient positioning

The patient is positioned laterally on a radiolucent table or a standard operating table with a radiolucent extension.

All of the bony prominences are padded to prevent pressure sores. Particularly important is protection of the non-operative side peroneal nerve and ankle. Donut-shaped cushions or other pads must be placed with care to avoid any pressure on these locations. An axillary roll is placed beneath the dependent axilla.
Stabilize the upper body and pelvis with either a pneumatic bean bag or hip positioners.
Scissor the legs with the operative leg closest to the surgeon. It may be elevated on a foam pillow.

If desired, apply a tourniquet around the upper thigh.
Prepare the entire leg circumferentially, from toes to upper thigh. Drape so it is completely mobile.

C-arm placement

The C-arm should be placed on the side opposite the surgeon. It should be able to pass freely under the table for an AP view.

Padding under the operated leg should be thick enough so that the opposite leg will not interfere with imaging.

v2.0 2012-05-13