A limb positioning and support device for achieving and maintaining reduction of a human bone in connection with surgical procedures involving orthopedic and other surgical fracture tables. The limb positioning and support device includes an articulating and rotating positioning and support arm coupled between a surgical table and a limb saddle. The positioning and support arm is configured to selectively allow translation and/or rotation of the limb saddle in three degrees of freedom. Actuation mechanisms drive the limb saddle vertically and horizontally. A pivot joint coupled between the limb saddle and the positioning and support arm permits rotation of the limb saddle about a vertical axis, and the limb saddle can be angularly displaced about the longitudinal axis of the subject limb. The limb saddle can be positioned and adjusted to bring fractured bone ends into alignment and hold the fracture stationary during the surgical procedure.