The Montague-Iliff Maneuver: A Simple Supine Suspension Positioning Technique for Olecranon Fracture Open Reduction Internal Fixation.
Year: 2026
Type: article
Abstract: Introduction: Posterior approaches for olecranon fracture fixation are traditionally performed in the prone or lateral decubitus position. While these positions provide direct access to the posterior elbow, they may introduce anesthetic challenges, logistical inefficiencies, and risks in polytrauma patients. Supine positioning offers anesthetic and ergonomic advantages but often requires assistants or cumbersome supports to maintain elbow flexion during exposure. We describe a simple, reproducible supine positioning technique - the Montague-Iliff Maneuver - that provides stable posterior elbow access without additional equipment or personnel. Technique: The patient is positioned supine. The operative extremity is flexed to 90° at the shoulder and elbow with approximately 90° of internal rotation. Sterile Kerlix is fastened circumferentially around the wrist and extended across the operative field, passed over IV poles on the contralateral side, and tensioned by anesthesia to suspend the arm above the patient's chest. Conclusion: The Montague-Iliff Maneuver provides a safe, efficient, and cost and time-effective alternative to prone or lateral positioning for posterior olecranon fixation. It facilitates anesthetic access, improves operative ergonomics, and eliminates the need for additional positioning devices or assistants.
Source: PubMed
Authors: Hansan Jones, Michael Montague, Anthony Iliff
Institution: Midwestern University
Language: English
Subfield: Orthopedics and Sports Medicine
Field: Medicine
Domain: Health Sciences
Open Access status: green
OpenAlex ID: W7225579397
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