- Supine for lateral access
Supine positioning for lateral access
This position and approach provide good access to the lateral proximal forearm, but medial access is quite limited. Repair of some olecranon and coronoid fractures may be difficult. Consider a more extensile approach, with the patient prone, or on his/her side.
Place the patient supine with the shoulder abducted and the arm positioned on a hand table. The elbow is flexed about 90° or as close as the arm rest permits without the hand hanging over its edge.
Make sure the shoulder is not retracted posteriorly to the body as this would stretch the nerves and vessels to the arm. Keep tension off the anterior shoulder by adding enough padding to the arm board that the shoulder/scapula do not fall backward.