Preoperative preparation

The outcome of surgery is strongly influenced by effective preoperative planning and preparation of the patient and operating room personnel (ORP).

Before treatment discuss the following information with the patient/parents/caregivers:

• Nature of the injury
• The chosen treatment and why a particular treatment is selected
• Alternative treatments
• General operative risks
• Expected healing time
• Functional recovery
• Implant removal
• Possible complications

Operating room personnel (ORP) need to know and confirm:

• Consent form, completed and signed
• Site and side of fracture
• Type of operation planned
• Surgical approach
• Operative site marked by surgeon
• Condition of soft tissues
• Equipment/implants needed
• Patient positioning
• Duration of operation
• Positioning of image intensifier
• Antibiotic prophylaxis
• Comorbidities, including allergies

The surgeon should ensure that:

• Relevant x-rays and other images are available in the OR
• Required instruments and implants are accessible and ready
• Image intensification is available
• There is a clear, step-by-step plan of the operation, including backup plans
• Intraoperative x-ray documentation should be undertaken, with clear AP and lateral views, before leaving the OR