Based on the references provided, the advantages of the lateral position include: facilitates the retraction of the vastus lateralis, allows hip flexion to aid reduction, improves access to the proximal segment (easier to get starting point). Disadvantages of the lateral position include: intraoperative imaging may be more difficult, rotation is more difficult to judge, and lateral positioning may not be practical in the polytraumatized patient.
Advantages of the supine position include: may help protect a potentially unstable spine, facilitates access to sites other than the injured femur, shorter setup time, rotational and angulatory deformities may be more easily appreciated. Disadvantages of the supine position include: starting point localization may be more difficult.
Wolinsky P, Stephen DJG: Femur, shaft (including subtrochanteric fractures) in, Ruedi TP, Buckley RE, Moran CG (eds): AO Principles of Fracture Management, ed 2. Stuttgart, Germany, Thieme, 2007, pp 767-785
Chapman MW: Fractures of the hip and proximal femur, in Chapman MW (ed): Chapman’s Orthopaedic Surgery, ed 3. Philadelphia, PA, Lippincott, 2001, pp 617-670
Skeletal Trauma : Basic Science, Management, and Reconstruction. (4th Edition) B. Browner, A. Levine, J. Jupiter, P. Trafton, Saunders Elsevier, Philadelphia, PA. Copyright 2009