Open Reduction & Internal Fixation of Fracture
What is it?
Open Reduction and Internal Fixation (ORIF) of Fracture is a surgical procedure that is performed to fix broken bones. It is usually done in two stages. In the first stage, the bone is reduced or put in back in place. In the next stage, the surgeon will place an internal fixation device on the bone. This is usually done using screws, plates, rods or pins to hold the broken bone together.
This is usually performed to repair the fractures that will not be able to heal correctly using just casting or splinting alone.
The doctor will perform the following before performing the ORIF as broken bones are typically caused either by trauma or from an accident,
- Physical Examination: is done to evaluate the effect of the broken bone on the patient’s blood circulation and nerves.
- Diagnostic Tests: like X-rays, CT Scan or MRI scan might be done to check the broken bone as well as the surrounding area and structures.
- Blood Tests: to check for any underlying medical issue like diabetes etc.
- Tetanus Shots: will be done depending on the fracture type and if the immunization is not correct.
Once the Open Reduction & Internal Fixation of the fracture surgery has been confirmed, the patient will be asked to
- Avoid food and drink a couple of hours before the procedure
- Avoid taking certain medications
The ORIF of fracture procedure usually takes a couple of hours, depending on the severity of the fracture and the broken bone.
The ORIF of the fracture procedure depends on the type of fracture and its location. Before the procedure begins, the patient will be administered either of the following anesthesia, depending on the location of the fracture and the time required for the surgery:
- General Anesthesia: will render the patient unconscious during the whole operation and a breathing tube will be used to help the patient breathe during the procedure.
- Local Anesthesia: will numb only the area being operated upon and is usually administered in the spine.
Once the patient is under anesthesia, the doctor will wash the skin with an antiseptic and then create the incision near the affected area. Then the surgeon will put the broken bone in place.
Once the broken is in position, the surgeon will attach a plate with screws, a pin or a rod that goes through the bone, to the bone holding the broken parts together. The surgeon will now close the incision using staples or stitches and then apply either dressing or a cast.
After the surgery, the patient will be kept under observation for a couple of hours to monitor the blood pressure and breathing. The doctor will also check the pulse and the nerves present close to the broken bone.
The patient will have to stay at the hospital for a week or so and will be discharged once the doctor is sure of the patient’s healing process. The doctor usually recommends the following:
- Physical Therapy, where specific exercises will be taught to regain the muscle strength and range of motion of the affected area.
- Make use of assisted devices, like crutches etc., depending on the location of the broken bone.
- Keep the affected limb elevated to above the heart to decrease the swelling.
- Always keep the incision covered to prevent infection
The patient is advised to visit the doctor immediately if he/she experiences the following,
- Fever or chills
- Redness, swelling or increasing pain
- Loss of feeling in the affected area
- Ineffectiveness of pain medications
- Joint pain, fatigue, stiffness or rash
- Bleeding or discharge from the incision area