• Nicolas Bonnaig, Steven Dailey, and Michael Archdeacon.
• 1363 Coppershire Cove South, Apt. 104, Germantown, TN 38138.
• J Bone Joint Surg Am. 2014 Jul 2; 96 (13): 1135-1140.

Abstract➤ The consequences of improper intraoperative positioning can be profound: it not only may cause substantial morbidity but also may be a major area of litigation, particularly when peripheral nerve injury occurs.➤ The ulnar nerve is most likely to be injured secondary to improper positioning. The elbow should be flexed ≤90° and the forearm placed in a neutral or slightly supinated position intraoperatively to minimize pressure in the cubital tunnel.➤ Pressure-related complications, such as pressure ulcers and alopecia, are best avoided by the use of adequate padding. Cushions on the operating-room table and armrest should be emphasized under osseous prominences.➤ Positioning the head in a non-neutral alignment or arm abduction of ≥90° may result in injury to the brachial plexus.➤ The hemilithotomy position increases intracompartmental pressure in the leg on the uninjured side. The risk of well-leg compartment syndrome can be minimized by avoiding this position if possible.Copyright © 2014 by The Journal of Bone and Joint Surgery, Incorporated.

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