Supine position

The supine patient position with the arm on a radiolucent arm board can be used for anterior and anterolateral approaches to the humeral shaft.

Consider the additional material on preoperative preparation.

The addition of regional and local anesthesia may reduce postoperative pain.

Antibiotics are administered according to local policy and specific patient requirements.

The patient is positioned with the fractured extremity as close as possible to the edge of the table.

It may be necessary to rest the shoulder on the arm table to allow unimpeded imaging.

This may require gentle lateral flexion of the neck and trunk with appropriate padding and attention to pressure areas.

By abducting the shoulder, it is possible for the surgeon and the assistant to sit on opposite sides of the hand table.

There are two possible positions for the C-arm:

• Parallel to the operating table
• Perpendicular to the operating table

Disinfect the entire arm down to the fingertips, with an assistant holding the arm with gentle traction to avoid neurovascular injury.

Drape the hand in a glove or leave it free.

Drape the arm up to the axilla.

The optimal position of the surgeon is defined by anatomical requirements of the fixation and may need to be changed during surgery.

The position of the screen should allow a direct view for the surgeon.