{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,19]],"date-time":"2026-10-19T16:54:37Z","timestamp":1792428877064,"version":"4.5.0"},"reference-count":9,"publisher":"SAGE Publications","issue":"1","license":[{"start":{"date-parts":[[2016,10,26]],"date-time":"2016-10-26T00:00:00Z","timestamp":1477440000000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/journals.sagepub.com\/page\/policies\/text-and-data-mining-license"}],"content-domain":{"domain":["journals.sagepub.com"],"crossmark-restriction":true},"short-container-title":["Foot &amp; Ankle Specialist"],"published-print":{"date-parts":[[2017,2]]},"abstract":"<jats:p>Prone positioning affords significant benefits for the fixation of trimalleolar ankle fractures and has been the long-time standard for treatment of these injuries. However, 2 primary disadvantages hamper its utility. First, access to the medial ankle is impeded by the contralateral limb and inability to rotate the operative leg to the extent that is possible in other positions. Second, lateral fluoroscopic imaging of the ankle can be cumbersome and often necessitates physically elevating the ankle for a radiograph then placing it back on the operative table. We describe a simple and cost-conscious technique for overcoming these obstacles of prone positioning in ankle fracture surgery. Judicious placement of a radiolucent triangle under the nonoperative leg in the prone position allows for unobstructed access to the medial ankle in conjunction with simplified lateral fluoroscopic imaging. An alternative technique is to place the radiolucent triangle under the operative leg with the bed in reverse Trendelenberg. Surgeons should consider adding these positioning techniques to their operative armamentarium for usage in appropriate cases.<\/jats:p>\n                  <jats:p>\n                    <jats:bold>Levels of Evidence:<\/jats:bold>\n                    Level V\n                  <\/jats:p>","DOI":"10.1177\/1938640016675411","type":"journal-article","created":{"date-parts":[[2016,10,26]],"date-time":"2016-10-26T20:18:47Z","timestamp":1477513127000},"page":"51-54","update-policy":"https:\/\/doi.org\/10.1177\/sage-journals-update-policy","source":"Crossref","is-referenced-by-count":5,"title":["Radiolucent Triangle as a Positioning Tool to Simplify Prone Ankle Fracture Surgery"],"prefix":"10.1177","volume":"10","author":[{"given":"Kamran S.","family":"Hamid","sequence":"first","affiliation":[{"name":"Department of Orthopaedic Surgery, Duke University Medical Center, Durham, North Carolina"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Travis J.","family":"Dekker","sequence":"additional","affiliation":[{"name":"Department of Orthopaedic Surgery, Duke University Medical Center, Durham, North Carolina"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Peter W.","family":"White","sequence":"additional","affiliation":[{"name":"Department of Orthopaedic Surgery, Duke University Medical Center, Durham, North Carolina"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Samuel B.","family":"Adams","sequence":"additional","affiliation":[{"name":"Department of Orthopaedic Surgery, Duke University Medical Center, Durham, North Carolina"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"179","published-online":{"date-parts":[[2016,10,26]]},"reference":[{"key":"e_1_3_1_2_2","first-page":"487","article-title":"Posterolateral approach for open reduction and internal fixation of trimalleolar ankle fractures","volume":"48","author":"Talbot M","year":"2005","unstructured":"Talbot M, Steenblock TR, Cole PA. Posterolateral approach for open reduction and internal fixation of trimalleolar ankle fractures. Can J Surg. 2005;48:487-490.","journal-title":"Can J Surg"},{"key":"e_1_3_1_3_2","doi-asserted-by":"publisher","DOI":"10.1053\/j.jfas.2011.04.022."},{"key":"e_1_3_1_4_2","doi-asserted-by":"publisher","DOI":"10.1302\/0301-620x.95b10.32527."},{"key":"e_1_3_1_5_2","doi-asserted-by":"publisher","DOI":"10.1177\/1071100714524551."},{"issue":"11","key":"e_1_3_1_6_2","first-page":"116","article-title":"How not to cut health care costs","volume":"92","author":"Kaplan RS","year":"2014","unstructured":"Kaplan RS, Haas DA. How not to cut health care costs. Harv Bus Rev. 2014;92(11):116-122, 142.","journal-title":"Harv Bus Rev"},{"issue":"9","key":"e_1_3_1_7_2","first-page":"46","article-title":"How to solve the cost crisis in health care","volume":"89","author":"Kaplan RS","year":"2011","unstructured":"Kaplan RS, Porter ME. How to solve the cost crisis in health care. Harv Bus Rev. 2011;89(9):46-52, 54, 56-61.","journal-title":"Harv Bus Rev"},{"key":"e_1_3_1_8_2","doi-asserted-by":"publisher","DOI":"10.1002\/cncr.29743."},{"key":"e_1_3_1_9_2","doi-asserted-by":"publisher","DOI":"10.3113\/fai.2012.0746."},{"key":"e_1_3_1_10_2","doi-asserted-by":"publisher","DOI":"10.1177\/1071100715615398."}],"container-title":["Foot &amp; Ankle Specialist"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/journals.sagepub.com\/doi\/pdf\/10.1177\/1938640016675411","content-type":"application\/pdf","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/journals.sagepub.com\/doi\/full-xml\/10.1177\/1938640016675411","content-type":"application\/xml","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/journals.sagepub.com\/doi\/pdf\/10.1177\/1938640016675411","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2026,4,28]],"date-time":"2026-04-28T21:33:26Z","timestamp":1777412006000},"score":1,"resource":{"primary":{"URL":"https:\/\/journals.sagepub.com\/doi\/10.1177\/1938640016675411"}},"subtitle":["Technical Tip"],"short-title":[],"issued":{"date-parts":[[2016,10,26]]},"references-count":9,"journal-issue":{"issue":"1","published-print":{"date-parts":[[2017,2]]}},"alternative-id":["10.1177\/1938640016675411"],"URL":"https:\/\/doi.org\/10.1177\/1938640016675411","relation":{},"ISSN":["1938-6400","1938-7636"],"issn-type":[{"value":"1938-6400","type":"print"},{"value":"1938-7636","type":"electronic"}],"subject":[],"published":{"date-parts":[[2016,10,26]]}}}