Prone for medial approach

Advantages

• Good access to medial aspect of elbow (eg, medial epicondyle/condyle)
• Varus stress associated with position facilitates fracture reduction
• Flexed position of the elbow reduces the tension in the flexor pronator mass also facilitating reduction

Disadvantages

• Use of the C-arm is more difficult
• More demanding for anesthetist

The patient is positioned prone with the injured elbow flexed and shoulder internally rotated to produce the “arm lock” position.

The limb is draped to allow the required surgical access, with the hand free; a high-arm, sterile tourniquet is applied, if required.