The patient is placed in a lateral position with all bony prominences padded. The affected top leg is extended. The bottom leg is flexed and positioned more anterior.
The use of a tourniquet is necessary in open and direct reduction of articular fractures.
It is also helpful in open direct reduction and screw and plate fixation. It is not necessary whenever MIPO techniques are employed. It is contraindicated for the insertion of external fixator pins, in intramedullary nailing, and under most circumstances when dealing with open fractures.
C-arm positioning must allow for perpendicular images of the plateau, especially accounting for the posterior slope of the proximal tibia. As well a true lateral image must be easily obtainable. The C-arm should be placed anterior to the patient.