Prone positioning

The patient is positioned prone on a radiolucent table. This gives good access to allow fixation of the Volkmann fragment and fibular fracture through a posterolateral approach.

Attention should be paid to the following points:

• The abdomen should hang free to avoid high intraabdominal pressure.
• The arms/shoulders should be resting comfortably in a 90-90° position of the shoulder and elbow.
• Adequate padding needs to be provided to elbows and knees to avoid pressure sores.
• A pillow or other support is placed under the front of the ankle to allow the toes to hang free.
• The head is best placed in a face mask to avoid pressure on the eyes and have the endotracheal tube free with the neck in neutral position.