Lateral recumbency

A lateral recumbency position can be used for medial and cranial plating. It is also used for procedures performed through a minimally invasive osteosynthesis (MIO) approach.

Preparing the entire leg, including the foot in the surgical field, helps in assessing the alignment.

Positioning the patient depends on surgeon's preference. Hanging the limb during preparation facilitates traction on the fracture and fracture alignment.

The patient is placed on the surgery table in a lateral oblique recumbency position. For a cranial or craniomedial approach, the affected limb is placed down in contact with the table. For the lateral approach to the radius and ulna, the affected limb is placed up.

Preparation of the limb is done outside of the surgical suite. The entire limb is clipped circumferentially, starting from the medial humerus to the entire foot. The clipped hair is vacuumed.

A general scrub is done before bringing the patient into the operating room.

In the operating room, the limb is put into a lateral hanging limb position. The limb is prepared for aseptic surgery by performing the final sterile surgical scrub.

Corner drapes are placed around the surgical site and secured with towel clamps.

An assistant releases the distal limb from the hung position while the surgeon grasps and covers the entire antebrachium with an adhesive incisional drape to prevent the surgeon from contacting the skin during the operation.

To improve the adhesion of the incisional drape, the skin should be dried with a sterile towel and a sterile adhesive spray should be applied over the entire surface to be covered.

An extremity or laparotomy drape covering the entire surgery table is recommended on top of the corner drapes.

If a MIO approach is used or an articular fracture is treated, the use of a C-arm may be helpful.