Authors of section


Andrew Howard, Theddy Slongo

Executive Editor

Fergal Monsell

General Editor

Chris Colton

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Preoperative preparation

1. Introduction

The success of a surgery is directly related to an effective preoperative planning and both preparation of the patient and of the operating room personnel (ORP).

2. Patient information

The following information should be given to the patient/parents/carers prior to treatment:

  • The nature of the injury
  • Open and comprehensive information about the chosen treatment technique and explanation of why a particular treatment has been chosen
  • Information about alternative treatments
  • Information about general operative risks
  • Expected healing time
  • Information about functional recovery
  • Information that a further procedure may be required for implant removal

3. ORP information

ORP should be informed about:

  • Equipment/implants needed
  • Site and side of the fracture
  • Positioning of patient
  • Surgical approach
  • Positioning of the image intensifier
  • Duration of operation

4. Surgical planning

The surgeon should make sure that:

  • The relevant x-rays and other images are available in the OR
  • The required instruments and implants are available and ready
  • The use of a tourniquet is possible (if available, a sterile tourniquet, which allows better and more sterile draping of the patient, should be chosen)
  • Image intensification is available in case of intraoperative problems. Normally, image intensifiers are not needed during open operations. If possible, intraoperative x-ray documentation should be undertaken, with clear AP and lateral views, before applying any plaster cast
  • There is a clear, step-by-step plan of how to conduct the operation, including back-up plans
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