Maquet T5540000 190

15.1.4 Prone position/CRP horseshoe headrest . . . . 192

15.1.5 Prone position/spine holding unit/

skull clamp 194

15.2 Thoracic spine, lumbar spine 196

15.2.1 Prone position 196

15.2.2 Lateral position 198

15.2.3 Supine position 200

16 Pelvis 203

16.1 Pelvic girdle 204

16.1.1 Supine position 204

16.1.2 Lateral position 206

16.1.3 Prone position 208

16.2 Acetabulum 210

16.2.1 Supine position 210

16.2.2 Lateral position 212

16.2.3 Prone position 214

17 Upper extremities 217

17.1 Shoulder 218

17.1.1 Supine position 218

17.1.2 Beach-chair position 220

17.1.3 Prone position 222

17.2 Upper arm 224

17.2.1 Supine position 224

17.2.2 Prone position 226

17.3 Elbow 228

17.3.1 Supine position 228

17.3.2 Prone position 230

17.4 Lower arm and hand 232

17.4.1 Supine position 232

18 Lower extremities 235

18.1.1 Supine position 236

18.1.2 Lateral position 238

18.2.1 Supine position 240

18.2.2 Modified supine position 242

18.2.3 Lateral position 244

18.3.1 Supine position 246

18.3.2 Prone position 248

18.4 Lower leg 250

18.4.1 Supine position 250

18.5 Foot 252

18.5.1 Supine position 252

18.5.2 Lateral position 254

18.5.3 Prone position 256

19 Positioning on the extension table 259

19.1 Extension table proximal femur 260

19.1.1 Supine position 260

19.2 Extension table thigh 262

19.2.1 Supine position 262

19.3 Extension table lower leg 264

19.3.1 Supine position 264

20 Arthroscopic procedures 267

20.1 Shoulder 268

20.1.1 Beach-chair position 268

20.1.2 Lateral position 270

20.2 Hips 272

20.2.1 Supine position on extension table 272

20.3 Knee 274

20.3.1 Supine position 274

20.4 Foot/ankle 276

20.4.1 Supine position 276

21 Paediatric surgery 279

21.1 Various positions 280

21.1.1 Supine position 280

21.1.2 Prone position 282

21.1.3 Lateral position 284

21.1.4 Lithotomy position 286

22 Special aspects of Iso-C3D and navigation applications 289

22.1 Iso-C3D applications with and without navigation 290

22.1.1 Spine 290

22.1.2 Pelvis/Acetabulum 294

22.1.3 Elbow/wrist 296

22.1.4 Hips/DHS/neck of the femur:

screwed solutions 298

22.1.5 Head of the tibia and lower leg 300

22.1.6 Ankle/pilon/talus 302

22.1.7 Calcaneus fractures 304

Subject Index 307

Staff directory

Aschemann, Dirk

Maquet GmbH & Co.KG, Product Manager Mobile Operating Tables Kehler Straße 31, 76437 Rastatt

Dr. Becker, Armin, MD

Urological Clinic, Hannover Medical School Carl-Neuberg-Straße 1, 30625 Hannover

Dr. Bund, Michael, MD

Medical Director, Clinic for Anaesthesiology, Surgical Intensive Care and Pain Therapy Albert Schweitzer Hospital Sturmbäume 8-10, 37154 Northeim

Böttcher, Volker, graduate engineer

Ziehm Imaging GmbH Isarstraße 40, 90451 Nürnberg

Colberg, Heinz

Sternenstr. 16, 76473 Iffezheim

Dr- Debong, Bernhard,

Lawyer, Legal Practice for Medical Law, Killisfeldstraße 62A, 76227 Karlsruhe (Durlach)

Trauma Department, Hannover Medical School Carl-Neuberg-Straße 1, 30625 Hannover

Hausmann, Volker, graduate engineer

Electrical/communications engineering, Product Manager Electrosurgical tyco Healthcare Deutschland GmbH Auf der Höhe 15, 53859 Niederkassel

Trauma Department, Hannover Medical School Carl-Neuberg-Straße 1, 30625 Hannover

Professor Dr. Kasperczyk, Werner-J., MD

Medical Director, Clinic for Traumatology, Orthopaedic Surgery Klinik St. Theresia Saarbrücken Rheinstrasse 2, 66113 Saarbrücken

Dr. Kendoff, Daniel, MD

Trauma Department, Hannover Medical School Carl-Neuberg-Straße 1, 30625 Hannover

Klimpel, Herbert, graduate engineer

TÜV Nord X-Ray Technology Am TÜV 1, 30519 Hannover

Kreienfeld, Helmut, graduate engineer

TÜV Nord X-Ray Technology. Head of Study Group Am TÜV 1, 30519 Hannover

Professor Dr. Krettek, Christian, MD

FRACS, Director of the Trauma Department, Hannover Medical School Carl-Neuberg-Straße 1, 30625 Hannover

Dr. Kofidis, Theo, MD

Clinic for Thorax, Heart and Vascular Surgery, Hannover Medical School, Carl-Neuberg-Straße 1, 30625 Hannover

Kulik, Bernhardt

Maquet GmbH & Co.KG, Product Manager Operating Table Sysems

Kehler Straße 31, 76437 Rastatt

Dr. Leonhardt, Johannes, MD

Paediatric Surgery Clinic, Hannover Medical School Carl-Neuberg-Straße 1, 30625 Hannover

Dr. Logemann, Frank, MD

Anaesthesiology Centre, Hannover Medical School Carl-Neuberg-Straße 1, 30625 Hannover

Dr. Mahlke, Lutz, MD

Trauma Department, Hannover Medical School Carl-Neuberg-Straße 1, 30625 Hannover

Professor Dr. Müller-Vahl, Hermann, MD

Neurology Clinic with Clinical Neurophysiology, Hannover Medical School Carl-Neuberg-Straße 1, 30625 Hannover

Priscoglio, Claudio

Maquet GmbH & Co.KG, -Product Manager AWIGS/VIWAS Kehler Straße 31, 76437 Rastatt

Rösinger, Charly

Maquet GmbH & Co.KG, -Product Manager Accessories Kehler Straße 31, 76437 Rastatt

Professor Dr. Scheumann, Georg, MD

Clinic for Visceral and Transplantation Surgery, Hannover Medical School Carl-Neuberg-Straße 1, 30625 Hannover

Dr. Schmidt, Ulf, MD

Department for Traumatology, Hospital of the Merciful Sisters, Schlossberg 1, 4910 Ried/Innkreis, Austria

Professor Dr.Sümpelmann, MD

Anaesthesiology Centre, Medical University Hannover Carl-Neuberg-Straße 1, 30625 Hannover

Professor Dr. Ure, Benno, MD

Director of the Paediatric Surgery Clinic, Hannover Medical School Carl-Neuberg-Straße 1, 30625 Hannover

Illustrations and picture processing

Dirk Aschemann, Armand Lang, Philippe Lang, Katrin Adam

Walter Mayrhofer Fotostudio Mayrhofer Weingartener Straße 62, 75045 Walzbachtal/Jöhlingen

Models:

Martina Prüser and Ute Gerber

Note

The following text describes various positioning techniques used in our clinic. Naturally, procedures can vary from clinic to clinic. The aim must of course be to use positioning which gives the patient optimum protection and provides the surgeon with optimum exposure of the operating site.

In view of the fact that every institution has developed its own quality standards (QS) for positioning, 4 we have not included any indications of quantities for positioning aids such as pads, safety belts, etc. in the »Preparation« sections 4 the positioning techniques are illustrated for the most part by a model without any precautions against bed sores, given the wide range of different positioning aids used in each different institution.

Furthermore,

4 the illustrations with models do not use any X-ray protection for C-arm use; these measures must be implemented according to the QS!

4 the chapters do not feature all conceivable risks but deal specifically just with the risks involved with the specific position. General damage to skin and nerves must naturally still be expected from incorrect positioning.

We have made every effort to provide a comprehensive overview of possible positioning variations. But we do not make any claim to covering absolutely every kind of positioning, indication and risk. We feel it is important to stress once again that patient positioning is a joint task to be shared by the nursing staff and doctors both in the surgical and in the anaesthesia team, and must be implemented and monitored by the whole team.

Prof. Dr. Christian Krettek Dr. Lutz Mahlke Dirk Aschemann

I General Part

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