This position is recommended for very proximal fractures because finding the nail entry-point is easier. However, it is more time consuming and iatrogenic injuries to the pudendal nerve have been documented, due to prolonged or excessive traction. This position is also recommended for obese patients.
Careful pre-cleaning of the soft tissues should be performed especially if gross contamination occurs.
Operating room personnel (ORP) need to know and confirm:
This procedure is performed with the patient under general or regional anesthesia
Long-lasting postoperative complete pain blocks for the patient with injured leg should be avoided as this could hide symptoms of a subsequent compartment syndrome.
Alternatively, additional traction at the knee joint may be applied to take account of any flexion of the proximal fracture fragment.