Preoperative preparation
1. Introduction
The outcome of surgery is strongly influenced by effective preoperative planning and preparation of the patient and operating room personnel (ORP).
2. Patient information
Before treatment discuss the following information with the patient/parents/caregivers:
- Nature of the injury
- The chosen treatment and why a particular treatment is selected
- Alternative treatments
- General operative risks
- Expected healing time
- Functional recovery
- Implant removal
- Possible complications (including a high risk of growth disturbance)
3. Information for operating room personnel
Operating room personnel (ORP) need to know and confirm:
- Consent form, completed and signed
- Site and side of fracture
- Type of operation planned
- Surgical approach
- Operative site marked by surgeon
- Condition of soft tissues
- Equipment/implants needed
- Patient positioning
- Duration of operation
- Positioning of image intensifier
- Antibiotic prophylaxis
- Comorbidities, including allergies
4. Surgical planning
The surgeon should ensure that:
- Relevant x-rays and other images are available in the OR
- Required instruments and implants are accessible and ready
- Image intensification is available
- There is a clear, step-by-step plan of the operation, including backup plans
- Intraoperative x-ray documentation should be undertaken, with clear AP and lateral views, before leaving the OR
