Supine position on a fracture table is used for application of a ring fixator when circumferential access to the leg is required. Additionally, the fracture should be aligned.
Open reduction and fixation of the tibial articular surface and / or fibula may be done as a first stage. This is often easier with the leg free on the table surface, using a distractor or external fixator if desired. Thereafter, leg suspension, as illustrated with the fracture table, eases application of the ring fixator.
Instead of a fracture table, the leg may be supported with a proprietary mobile reduction frame, or one improvised from modular external fixator components.
The use of a tourniquet should be considered if articular surface ORIF will be an initial stage. The leg is prepped from mid-thigh to toes.