Abstract: Objective: To explore the dilemmas faced by operating room medical staff in the position management of orthopedic surgery in prone position, and to provide references for improving the nursing quality of orthopedic surgery. Methods: Purposive sampling method was used to select 11 orthopaedic specialist nurses, 2 orthopaedic surgeons, and 2 anaesthesiologists in the operating theatre of a tertiary grade A hospital in Hubei province from March to May 2025 for semi-structured interviews. Thematic analysis was used to analyse the data. Results: Four main themes and six subthemes were identified, including insufficient professional competence of the surgical team (lack of skills and experience, poor team communication and coordination), difficulties in positioning high-risk patients, limitations in equipment and technical support (constraints of prone positioning devices, limited real-time monitoring technologies), and inadequate implementation of standards and procedures (unclear operational guidelines, insufficient assessment and feedback). Conclusion: Medical staff in operating rooms face multiple dilemmas and challenges in managing the prone position during orthopedic surgeries, which are related to key factors including the professional incompetence of medical personnel, individual patient variations, equipment and technical conditions, and process execution.

Key words: orthopaedic surgery; prone position; dilemma; operating room; qualitative study