- Supine position
This position allows free access to both the lateral and the medial sides by hip rotation and fluoroscopic imaging in both planes.
Position the patient supine on a radiolucent operating table extension with the foot brought to the end of the table. Elevate the injured leg on folded linen or a molded foam cushion. Place a bump consisting of a single rolled blanket beneath the ipsilateral hip. This will help avoid the leg’s tendency to externally rotate.
The image intensifier is on the side opposite the injured limb.
Prepp the entire leg from toes to upper thigh. Anticipate the possible need for autologous bone graft. Prepare a donor site and drape it if necessary.
A well-padded tourniquet should be applied to the thigh. Its inflation is determined by surgeon’s preference. Often omitted, it might be very helpful, especially during articular surface reconstruction.