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What Is ORIF?

A severely broken bone is typically covered with a cast after an open reduction internal fixation.
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  • Written By: Mary McMahon
  • Edited By: O. Wallace
  • Last Modified Date: 13 March 2014
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Open reduction internal fixation (ORIF) is an orthopedic surgical procedure which is utilized to treat severe fractures. The hip is a bone which commonly requires an ORIF procedure after a fracture, although this procedure can be performed on other bones in the body as well. It is usually done in a sterile operating environment by an orthopedic surgeon with a support team which includes an anesthesiologist to manage the patient along with operating room nurses to assist with tools, maintenance of a sterile environment, and positioning the patient.

There are two separate components to an ORIF procedure. The first is the “open reduction” part, which refers to using open surgery to set the bones. Open surgery may be required when a fracture is complex or there are many pieces of bone. The surgeon makes an incision in the area of the break to access the involved bone or bones, and manipulates them back into place, checking with an x-ray machine to confirm that the fracture has been fully addressed.

The internal fixation involves the use of pins, plates, and screws to hold the bones in place. This is done because the bones cannot heal with casting or splinting alone. The internal fixators hold the bones together as they begin to heal. Sometimes they are simply left in place, and in other instances, they may be removed when healing is complete. Healing is monitored with the assistance of medical imaging to confirm that the bones are knitting, healing evenly, and healing correctly.

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When an ORIF is recommended, the patient needs to prepare for surgery. This involves meeting with the anesthesiologist and the surgeon to discuss risks and concerns, following directions such as refraining from eating or drinking before the procedure, and showing up at the hospital at the appointed time. The patient will be fully anesthetized during the procedure for comfort and will be offered pain management after the ORIF surgery while she or he recovers.

Once bones are set with ORIF, the patient has an opportunity to engage in physical therapy. Usually patients are encouraged to start physical therapy as soon as it is safe and practical to do so, to reduce the risk that their muscles will atrophy. Physical therapy also promotes healing, because exercise stimulates blood flow. Patients may also find that light exercise helps them deal with anxiety and depression, two symptoms which can be encountered in the wake of a major injury and surgery such as ORIF.

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Discuss this Article

amypollick
Post 7

@anon278912: It means the doctors take frequent X-rays or maybe CT scans of the bones to see if they're growing back together properly and are healing.

anon278912
Post 6

"Healing is monitored with the assistance of medical imaging to confirm that the bones are knitting, healing evenly, and healing correctly." Please reply with details.

anon151183
Post 5

what is the shortest possible time that an implant be removed after an orif? my 11 year old son has an orif and the ortho said his stainless be removed after six weeks. is it all right?

anon149330
Post 4

my son had an orif two weeks ago. what are some complications that might come in the process.

naturesgurl3
Post 3

It's really important to keep up with that physical therapy after getting an ORIF -- a lot of people have trouble balancing afterwards, particularly those with ankle or hip ORIFs.

closerfan12
Post 2

@lightning88 -- Although it's not for sure, pain could be a sign of loose screws. Sometimes after the ORIF has been in there a while the screws start to wiggle out, and it could be hitting a nerve.

I would ask your orthopedist about it just to be sure, but it's not very common for them to take it out just like that.

They'll be able to X-ray it for you and tell you what's going on, and also give you something for the pain.

Best of luck!

lightning88
Post 1

I had an ORIF in my ankle about a year ago and I was wondering how I would know if the screws started to get loose.

It's not terribly painful, just tingly sometimes and numb. I didn't know if that was normal, or if it could be a sign of something wrong.

Anybody out there experienced anything like this, or know what I should do?

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