Leg (tibia and fibula)
Published online by Cambridge University Press: 06 December 2010
Summary
Supine position (with traction)
(Figure 79)
Supine position on an orthopaedic traction table, with leg extension supports replacing the conventional foot end of the table (see Figure 9)
Insert a vertical bar between the patient's legs into an appropriate hole in the table. The patient may need to be lifted up the table temporarily to achieve this.
The correct hole is usually to the same side as the leg to be operated on. Attach a well-padded horizontal cylindrical post to the vertical bar (Figure 80) and then lift the leg over the post
In conjunction with the anaesthetist looking after the head and neck of the patient, lift the patient down against the horizontal post so that the post supports the distal thigh of the ipsilateral leg and the hip is flexed to approximately 70–90°. Do not allow the post to press into the popliteal fossa, where it may cause nerve injury. Side supports may need to be placed against the femoral condyles to stop the knee flopping sideways
Move each leg into position and secure it to the traction attachment. The configuration of the traction attachment will vary according to the desired method of applying traction (see below)
Remove each leg extension support
Adjust the position of the leg to be operated on and apply traction as required. As a precaution, support the leg with your hand as traction is applied
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- Positioning Patients for Surgery , pp. 80 - 85Publisher: Cambridge University PressPrint publication year: 2009