A Simplified Technique for Patient Positioning During Olecranon Fracture Fixation

Olecranon fractures are common injuries of the upper extremity that frequently require operative fixation to restore elbow congruity and function. Surgery is often performed in the lateral or prone position, presenting challenges for anesthesia, nursing, and the surgical team to safely and appropriately position the patient. Supine positioning with the use of a hand table provides limited visualization of the olecranon and often requires an assistant for maintenance of limb position. We describe an easy and quick surgical setup requiring only 2 total knee arthroplasty foot positioners (commonly known as “paint rollers”) attached to a surgical table with the patient in a supine position. A retrospective review of 28 patients undergoing operative fixation of olecranon fractures utilizing this positioning method was performed. No patients were found to require repositioning (ie, supine to lateral) for any reason and no airway-related or positioning-related complications were noted. This setup provides excellent exposure to the operative site and stable positioning of the arm with minimal risk to the patient. In keeping the patient supine, monitored anesthesia care (intravenous general anesthesia) with regional blockade may be performed without the need for endotracheal or laryngeal mask anesthesia, thereby lowering anesthesia-related risks.