Pelvic girdle

16.1.1 Supine position

O Figs. 16.1-16.6. Indications

Access to the front pelvic girdle, ilium, iliosacral joint and hip joint (Pfannenstiel, modified Stoppa, ilioinguinal, anterolateral, Judet, Smith-Peterson) for operating:

4 fractures, misalignment and posttraumatic lesions in the front pelvic girdle, ilium, iliosacral joint and at the symphysis 4 tumours, osteomyelitis, ossification 4 tamponade for pelvic bleeding 4 placement of the pelvic cingulum

Preparations

4 Arm positioning devices 4 Possibly table extension

4 Shaving in the area of the incision and preoperative skin cleansing Positioning

4 Standard operating table position 1, position 2 or universal operating table, possibly table extension 4 Anaesthetic preparation and induction in supine position with 2 adapted arm positioning devices 4 Normal positioning of the operating table in the theatre 4 When positioning the patient, take appropriate measures to prevent decubitus at areas which are subjected to pressure 4 Position both arms in the abduction position on the arm positioning devices

4 Apply the neutral electrode and connect to the HF surgery device 4 Arrange absorbent drapes or self-adhesive covers for preoperative skin disinfection 4 Position the operating lights 4 Patient warming system

Pelvic Fracture Position TableAlliance Surgical ClampsSurgery Position

O Figs. 16.7-16.9. Indications

Lateral, anterolateral and rear access to the ilium and iliosacral joint for operating:

4 fractures, misalignment and posttraumatic lesions of the ilium, pelvic column and iliosacral joint tumours, osteomyelitis, ossification, gluteal compartment syndrome exposure of the sciatic nerve

Preparations

4 Arm positioning devices

4 Gel ring, gel cushion, Goepel leg holder, side supports, radial adjusting clamps, padded cushions (normal and flat) and wedge cushions, tunnel cushions, body belts, possibly table extension 4 Shaving in the area of the incision and preoperative skin cleansing

Positioning

4 Standard operating table position 1, position 2 or universal operating table, possibly table extension 4 Anaesthetic preparation and induction in supine position with 2 adapted arm positioning devices 4 Normal positioning of the operating table in the theatre 4 When positioning the patient, take appropriate measures to prevent decubitus at areas which are subjected to pressure 4 Fit the radial adjusting clamp to the rail of the head plate, position the

Goepel leg holder 4 Spread out the arm on the side not being operated 4 Move the patient onto the healthy side

4 Move the lower arm forwards so that the weight of the upper body does not lie directly on the shoulder 4 Fit the radial adjusting clamps to the side rails of the leg plates/head plate and position the body supports on the level of the sacrum of the symphysis and the scapula 4 1st possibility: position the legs with the padded cushions (normal and flat) and possibly wedge cushions 4 Fix the lower leg and the positioning aids with the body belts 4 2nd possibility: position the legs with the tunnel cushion 4 Apply the neutral electrode and connect to the HF surgery device 4 Arrange absorbent drapes or self-adhesive covers for preoperative skin disinfection 4 Position the operating lights 4 Patient warming system

Prone Positioning System
Fig. 16.7. Lateral position on CRP operating table 1150.16 with 2 CRP accessory adapters and lateral positioning cushion for anatomic positioning of the lower arm
Surgical Positioner For Lateral

D Fig. 16.8. Lateral position on universal operating table with vacuum mat

D Fig. 16.9. Lateral position on universal operating table with lateral positioning cushion and operating table in flex position for neutral position of the spinal column

D Fig. 16.8. Lateral position on universal operating table with vacuum mat

D Fig. 16.9. Lateral position on universal operating table with lateral positioning cushion and operating table in flex position for neutral position of the spinal column

O Figs. 16.10-16.13. Indications

Dorsal access to the sacrum, hip joint, iliosacral joint for: 4 fractures, misalignment and posttraumatic lesions in the area of the sacrum, iliosacral joint and hip joint 4 tumours, gluteal compartment syndrome 4 exposure of the sacral nerve and the sciatic nerve

Preparations

4 Arm positioning devices

4 Special head positioning pillow for prone position 4 Thorax, pelvic and wedge cushion, padded roll 4 Possibly table extension

4 Shaving in the area of the incision and preoperative skin cleansing Positioning

4 Standard operating table position 1, position 2 or universal operating table

4 Anaesthetic preparation and induction in supine position with 2 adapted arm positioning devices 4 Transfer to the prepared operating table in the induction room 4 Position both tables next to each other, with the prepared table lowered 4 Place the patient in prone position on the padded cushion of the prepared operating table and take him into the theatre 4 Normal positioning of the operating table in the theatre 4 When positioning the patient, take appropriate measures to prevent decubitus at areas which are subjected to pressure 4 Position the head on the special head positioning cushion 4 Position both arms on the arm positioning devices 4 Apply the neutral electrode and connect to the HF surgery device 4 Arrange self-adhesive covers for preoperative skin disinfection 4 Position the operating lights 4 Patient warming system

Prone Theatre CushionProne Theatre Cushion
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