- Supine position without traction
The patient is positioned supine on a radiolucent table. This positioning is recommended for bilateral fractures because it can allow for the reduction and fixation of both fractures without requiring redraping. However, the axial view may be difficult to obtain because elevation of the contralateral leg is required.
A firm cushion placed in the midline beneath the pelvis may be used to elevate the pelvis from the table edge and facilitate the skin incision.
The ipsilateral arm should not be positioned on an arm board or abducted, since it would interfere with nail insertion. An adducted (pictured) or elevated position is favored.
In case of nailing, adduct the fractured limb as necessary for entry point localization.