The Montague-Iliff Maneuver: A Simple Supine Suspension Positioning Technique for Olecranon Fracture Open Reduction Internal Fixation.
- 1Department of Orthopedic Surgery, Arizona College of Osteopathic Medicine, Midwestern University, Glendale, Arizona.
- 2OrthoArizona, Gilbert, AZ.
Abstract
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. 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. 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.
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BibTeX
@article{jones2026montagueiliff,
title = {{The Montague-Iliff Maneuver: A Simple Supine Suspension Positioning Technique for Olecranon Fracture Open Reduction Internal Fixation.}},
author = {Hansan Jones and Michael Montague and Anthony Iliff},
journal = {Journal of orthopaedic case reports},
year = {2026},
month = nov,
doi = {10.13107/jocr.2026.v16.i11.8486},
url = {https://europepmc.org/article/MED/42997064},
note = {CC BY-NC},
}
RIS
TY - JOUR
TI - The Montague-Iliff Maneuver: A Simple Supine Suspension Positioning Technique for Olecranon Fracture Open Reduction Internal Fixation.
AU - Hansan Jones
AU - Michael Montague
AU - Anthony Iliff
PY - 2026
DA - 2026/11/01
JO - Journal of orthopaedic case reports
DO - 10.13107/jocr.2026.v16.i11.8486
UR - https://europepmc.org/article/MED/42997064
AB - 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. 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. 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.
SN - 2250-0685
SN - 2321-3817
ER -