Authors of section


Andrew Howard, Theddy Slongo

Executive Editor

Fergal Monsell

General Editor

Chris Colton

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Prone for medial approach

1. Introduction


  • 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


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

2. Preoperative preparation

Consider the additional material on preoperative preparation.

3. Patient positioning

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.

open medial epicondylar reduction and internal fixation
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