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Discussion

Positioning for hand & elbow procedures

Hellow everyone,

I am a new nurse and just started working in the OR in an all ortho hospital. We are in the classroom phase right now and have been given assignments to do. We all were given a procedure or group of procedures to find information on, mine is hand and elbow.

I printed out anatomy pictures, I have info from zimmer on some instruments, but need help on a few things.

Positioning for elbow procedures? What positioning devices are used?

Same for hand procedures? What are the most common hand/elbow procedures that you see?

Any help would be GREATLY appreciated. Also any additionional info that you think is important for scrubbing or circulating in these types of procedures would be wonderful. Thank you!

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Most common hand procedures are carpal tunnel, ganglion excision, ORIFs.

Pt. is supine, with extremity table on operative side, to allow for more work room. Most of our surgeons sit for those procedures. It is also important for the ORIFs that the extremity table used is radiopaque.

The elbow, well, depends on what's being worked on.

There is a good article on medscape called "Preparation of the Operating Room: Introduction" - it isn't specific to hand/elbow, but may be helpful otherwise.

http://www.medscape.com/viewarticle/535622

You will have to register with them to read the article, but it is free.

Alexander's Care of The Patient In Surgery is a wonderful reference.

Surgical positioning is as much a personal surgeon preference as it is dictated by anatomy.

Having said this, I will tell you that I have done many elbow pocedures with the patient in semi-fowlers and the arm draped free across the pt. chest.

good luck,

Pj

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