Risks

4 Iatrogenic damage caused by inserting the Steinmann nail 4 Pressure injuries

4 Compartment syndrome from overdistraction

19.3 Extension table lower leg

19.3.1 Supine position

O Figs. 19.9-19.11. Indications

Medullary nailing, intramedullary reaming. Preparations

4 Two arm positioning devices

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

4 Universal operating table for traumatology and orthopaedic procedures (extension table)

4 Anaesthetic preparation and induction in supine position with 2 adapted arm positioning devices 4 If necessary, diagonal 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 Longitudinal adjustment of the operating table towards the feet (1150.20) 4 Fit the tibia device to the seat plate on the side being operated 4 Unlock the unit at the lower radial joint and lower towards the feet to improve scanning the knee in anteroposterior ray path after positioning 4 Lock the safety lever again

4 Insert the short telescopic bar in the extension bar on the side being operated 4 Fit the screw tension device

4 Fit the rotation tilt clamp to the screw tension device 4 Place a double wedge cushion on the operating table 4 Fit the arm positioning device to the side rails of the lower back plate on the side not being operated 4 Fit the side rails extension to the side rail of the seat plate 4 Fit the Goepel leg holder to the side rail extension with a radial adjusting clamp

4 Fit the anaesthesia screen with a radial adjusting clamp to the side rail of the upper back plate on the side not being operated 4 Fit the anaesthesia screen extensions and possibly suspend 2 arm straps 4 Fit the tension hoop before transferring the patient 4 Transfer the patient from the induction table to the prepared operating table in supine position 4 Fit the positioned Kirschner wire bow to the traction stirrup clamp with rotation, constantly pulling the leg 4 Position the healthy leg in the Goepel leg holder 4 Position the arms

4 Reposition the fracture using the image intensifier 4 Check all screwed and clamped connections 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

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