Elbow positioning
Supine arm in DHS leg support
Used for most procedures on the elbow.
Olecranon fixation, ulna nerve decompression, ORIF distal humerus and posterior approach to humerus, common flexor origin release, radial head ORIF/ replacement, boyd interval or kocher interval
 |
Position patient supine, with Loyd Davies (DHS) leg support (long gutter) coming from opposite side. Note normal anaesthetic arm gutters are not usually long enough. Make sure the long part reaches across the patient.
Place the knurled nut at the level of the contra lateral shoulder, ensure it is not placing pressure on the shoulder. Place a rolled up towel under the ipsilateral shoulder to just lift it up a little.
If the arm keeps slipping out tilt the table 2 clicks away from you.
The arm should stay in the gutter without holding it.
Move the knurled nut up and down the table if require more predominant access to ulna or radial side of elbow. |
Supine "L"Bar
Used when deep flexion is needed, ie. Total elbow replacement, some articular fractures of the distal humerus
 |
Place L bar on the side of the arm to be operated on.
Point it diagonally down the bed, so when the arm is drapped over it the hand tends to want to lie on the face.
Place a towel under the ipsilateral shouder.
If the arms wants to slip off, tilt the table 2 clicks away from you. |
Lateral with "U" bar or "L" bar
Used for elbow arthroscopies