An open reduction internal fixation (ORIF) refers to a surgical procedure to fix a severe bone fracture, or break. “Open reduction” means surgery is needed to realign the bone fracture into the normal position. “Internal fixation” refers to the steel rods, screws, or plates used to keep the bone fracture stable in order to heal the right way and to help prevent infection.
Open reduction internal fixation can also refer to the surgical repair of a joint, such as a hip or knee replacement.
The surgical procedure is performed by a doctor who specializes in orthopedics, which is a branch of medicine concerning the musculoskeletal structure of the body. Under general anesthesia, an incision is made at the site of the break or injury, and the fracture is carefully re-aligned or the joint replaced. The hardware is installed, and the incision is closed with staples or stitches. The steel rods, screws, or plates can be permanent, or temporary and removed when healing takes place.
Once the open reduction internal fixation is performed, a cast is usually applied. In the case of an ankle fracture, for instance, the first cast is a non-weight bearing cast, and crutches can be used to help keep weight off the healing bones. Later, when the healing has progressed, this cast will be replaced with one that can bear weight. Eventually, after a period of some weeks, the cast will be removed entirely.
Recovery from a bone fracture after an open reduction internal fixation can be quite painful, and pain management becomes a concern. Commonly, acetaminophen with codeine is prescribed, as research has shown ibuprofen or other non-steroid anti-inflammatory drugs (NSAIDs) may slow down or inhibit the rate of healing. It is important to take the drugs as prescribed to help manage the pain cycle.
Physical therapy is also an important part of the recovery process after an open reductioninternal fixation. Since the part of the body that has been injured is usually held still or immobilized for a long period of time, the muscles, tendons, and ligaments can become weak. Physical therapy helps to restore the strength, range of motion, and endurance of the affected area. It can also help with pain management. Physical therapy can consist of exercises, hot or cold packs, ultrasound, and nerve stimulation, or a combination of treatments.
Complications of ORIF can include infection, swelling, and movement of the installed hardware. The recovery process can take months, because bones grow slowly. Other factors that can affect recovery are the location and severity of the break, the age of the person, and the type of bone broken.