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
- Growth stimulation and possible leg length discrepancy
- Growth arrest and possible deformity
- Risk of persistent knee instability
- Associated intraarticular injuries
3. Information for operating room personnel
Operating room personnel (ORP) need to know and confirm:
- Consent form completed and signed
- Site and side of the fracture
- Type of operation planned
- Surgical approach
- Operative site marked by the 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
- An image intensifier is available
- There is a clear, step-by-step plan of the operation, including backup plans
- A detailed record of the procedure is made, including intraoperative surgical findings, final fluoroscopic images and, where relevant, arthroscopic pictures
