Semi-extended knee position for intramedullary nailing
1. Positioning
Place a bump underneath the ipsilateral buttock to prevent the limb from externally rotating during surgery. Prepare the limb from the ankle to the groin and drape the foot which will allow free mobility of the whole limb. Place a sterile pack under the knee to maintain 15–30 degrees of flexion. It is helpful to have a padded bolster underneath the foot and ankle to elevate it compared to the contralateral limb. This allows for easier intraoperative imaging of the entire tibia (so that the contralateral tibia is not superimposed).
2. C-arm positioning
C-arm positioning must allow for perpendicular (AP and lateral) images of the knee, entire tibia, and ankle. The C-arm should be placed on the non-injured side of the patient.
