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Well-leg positioning on a fracture table: using a pillow sling
1Vanderbilt Orthopaedic Institute, Medical Center East, Nashville, TN. jesse.bible@vanderbilt.edu.
American Journal of Orthopedics (Belle Mead, N.J.)
|December 10, 2014
Summary
Surgeons can avoid acute compartment syndrome from the lithotomy position by using a pillow and bandage to safely position the uninjured leg. This technique ensures clear imaging during fracture table procedures.
Area of Science:
- Orthopedic Surgery
- Surgical Complications
- Patient Positioning
Background:
- Acute compartment syndrome is a rare but serious complication associated with the lithotomy position.
- The risk of acute compartment syndrome has led some surgeons to avoid the traditional well-leg setup on fracture tables.
Purpose of the Study:
- To describe a safe and efficient technique for positioning the uninjured limb in a scissored position on a fracture table.
- To prevent acute compartment syndrome while facilitating optimal imaging during orthopedic procedures.
Main Methods:
- Utilized a pillow and a self-adherent compression bandage to position the well leg.
- Achieved relaxed hip and knee extension with limb adduction to the midline support bar.
- Ensured unobstructed lateral fluoroscopic imaging of the injured limb.
Main Results:
- The described technique reliably positions the uninjured limb in a scissored configuration.
- This positioning allows for clear lateral fluoroscopic views without well-leg overlap.
- The method prevents interference with C-arm positioning.
Conclusions:
- A novel, safe, and efficient method for well-leg positioning on a fracture table is presented.
- This technique mitigates the risk of acute compartment syndrome.
- It optimizes imaging capabilities for orthopedic interventions.
