The supine position with unilateral leg support offers excellent image intensifier access for the lateral views.
It also allows the surgeon to vary the degree of flexion of the knee at different stages of the procedure. A surgical assistant is needed to hold the lower leg in the correct position throughout the operation.
Place the patient supine on a radiolucent operating table and flex the knee of the injured leg, with the lower leg and foot hanging free.
This positioning allows for AP and lateral fluoroscopy, without further movement of the contralateral leg.
The contralateral leg should be well padded and positioned without pressure on the calf, in order to prevent peroneal nerve damage, or calf or thigh compartment syndromes.