The prone position provides access to the posteromedial approach.
This procedure is performed with the patient under general or regional anesthesia.
If a spinal anesthetic is used, the surgeon and anesthetist need to be confident that the procedure will not last more than 1.5 hours.
Antibiotics are administered according to local antibiotic policy and specific patient requirements.
Maintain light manual traction (the assistant may need to stand on a stool) on the limb during preparation to avoid excessive deformity at the fracture site.
Disinfect the whole leg from the hip including the foot with the appropriate antiseptic.
The surgeon and ORP stand on the side of the affected limb. The assistant usually stands on the opposite side to the surgeon and moves out of the way when the image intensifier is positioned.
When needed, the image intensifier is placed on the opposite side of the injury and the display screen in full view of the surgical team and the radiographer.