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Open reduction internal fixation (ORIF)

Surgery to repair severe fractures (bone breaks) and support healing

Surgeons performing open reduction internal fixation on a patient's knee joint
An open reduction internal fixation or ORIF is a surgical procedure to repair a fractured bone.

The open reduction part of the operation involves restoring displaced bones to their correct position and the internal fixation is where the bones are fixed into place with rods, plates, and screws.

ORIF is normally used for serious fractures that can't be treated with a cast or splint. The procedure can repair fractures of the ankle, shoulder, wrist, elbow, hip, or knee.

This page explains what ORIF is, why you may need ORIF, what happens during the procedure and what to expect afterwards.

Internal fracture repair

Please be aware that the following prices are a guide price. Your final price will be confirmed in writing following your consultation and any necessary diagnostic tests.

Patient pathway Initial consultation Diagnostic Investigations Main treatment Post discharge care Guide price
Hospital fees N/A Not included £9,400 Included £9,400
Consultants fees from £200 N/A Included Included £200
Guide price £9,600

ORIF is usually urgent surgery. You may need ORIF to repair a fracture where:

  • The bones are broken in more than one place
  • The bone is piercing the skin
  • The bones have moved out of position

You may also be offered ORIF if a previous fracture hasn't healed properly, or to avoid spending a long period of time in plaster.

At your first consultation, you will be seen by a consultant orthopaedic surgeon, a doctor specialising in conditions affecting the bones, joints, muscles, ligaments, and tendons.

Your consultant will ask you about your symptoms and what happened to cause the fracture. They will perform a physical examination and arrange for scans such as an X-ray, CT, or MRI to assess the injuries to your bone and soft tissue.

Your first consultation is also where we get to know you, discuss your expectations for treatment and encourage you to ask any questions you may have. It is important to us that you are as well-informed and comfortable as possible before, during, and after your surgery, so please ask your consultant any questions you may have.

At the end of your appointment, your consultant will decide whether ORIF is a suitable treatment for you based on your diagnosis.

ORIF is often performed as an emergency procedure, meaning there may be limited time for you to prepare.

Your consultant will explain what will happen during your surgery, any possible risks, and complications and what to expect during your recovery. Being well-informed about your surgery will help to ease any anxiety you may have, so please feel free to ask as many questions as you need to help put your mind at rest.

Tell your consultant about any medical conditions or allergies you have and any medication, including over-the-counter medicines you are taking.

In some cases, your ORIF may be postponed to allow swelling of the area around the fracture to subside. Your fractured bone will need to be immobilised in a cast or splint during this time.

Your consultant may tell you to stop taking some medications like blood thinners for a few days before your operation. This is to reduce the risk of bleeding during and after your surgery. You will not be able to eat or drink anything from midnight on the day of your operation.

Do I need to prepare my home for after my surgery?

Depending on the location of your fracture, you may need help getting around, or assistance with household tasks like shopping, cooking and cleaning for a few days or weeks after your ORIF.

If possible, prepare your home before your surgery to make things as easy as possible during your recovery. Some things you can do include:

  • Stock up your kitchen cupboards and freezer with easy-to-prepare food
  • Prepare single-portion meals that can be easily heated up
  • Remove items you could trip over such as low tables, magazine stands and rugs
  • Keep things you use frequently like books, medications, and the TV remote control within easy reach

ORIF surgery is split into two parts. In the first part of the procedure, your consultant makes an incision near the fracture site and manipulates the bones back into position. This is then checked with X-rays.

In the second part of the operation, the bones are fixed into position using internal fixators. These may be removed once the bone has healed or may remain in place.

When the surgery is finished, your consultant will close the incision using staples or stitches and apply a sterile dressing and a bandage to the wound. Depending on the location and type of fracture, your bone may be immobilised in a cast or splint.

ORIF is carried out under general anaesthetic meaning you will be asleep for the procedure. It normally takes around one to two hours but can take longer depending on the severity of the fracture.

After your surgery, you will be taken to the recovery room where you will be monitored closely until the effects of the anaesthetic have worn off. You will then be taken to your room.

Recovery from any type of surgery is different for everyone and depends on factors such as your age, general health and whether or not there were any complications during your surgery or recovery.

Your consultant will be able to give you an estimated recovery timeline based on your individual circumstances.

How many nights will I need to stay in hospital?

How long you need to stay in hospital after your ORIF depends on the type of surgery you had. For example, for an arm fracture you may be able to go home later the same day, but for leg fractures you can expect to spend a few days in hospital. Talk to your consultant about how long you can expect to stay in hospital after your surgery.

Will I be able to drive home?

You will not be able to drive yourself home from hospital after your open reduction internal fixation operation. Please plan for someone to come and collect you, or we can organise a taxi if you prefer.

How soon can I go back to work?

How soon you can go back to work after your ORIF depends on the type of surgery you had, your individual recovery, and the type of job you do. You can expect to return to a sedentary job such as office work sooner than a physically active or manual job.

Talk to your consultant about when you can expect to return to work after your ORIF.

How soon can I drive?

When you can drive after your ORIF depends on the type of fracture and what kind of surgery you had. You should not drive until you can safely control your vehicle and perform an emergency stop without pain.

Driving before you are ready could be dangerous and may invalidate your insurance. Make sure you check with your consultant and your insurance company before driving after your ORIF.

When will I be back to normal?

Recovery from ORIF is a gradual process that is different for everyone. How soon you recover fully from your ORIF depends on many factors such as your age, general health, the type, and severity of your fracture and whether there were any complications during your surgery or recovery.

After your surgery, your affected limb may be immobilised in a cast or splint while it heals. You will be given painkillers and antibiotics to manage any post-operative pain and prevent infection.

You will be given regular follow-up appointments to check that your fracture is healing properly. Stitches or staples are normally removed around a week to ten days after surgery.

Physiotherapy is an important part of your recovery. Our expert team of physiotherapists will show you some exercises to do during your recovery to help restore strength, flexibility, and range of motion.

Full recovery from ORIF normally takes between three months and one year.

As with all types of surgery, ORIF carries a small risk of complications. Your consultant will explain all the possible risks and complications before your surgery and answer any questions you may have about your procedure. Being as well-informed as possible about what to expect from your surgery will help put your mind at rest and allow you to make an informed decision, so please ask your consultant any questions you may have.

Possible complications of any surgery include:

  • Bleeding
  • Infection
  • Blood clots
  • Adverse reactions to the anaesthetic

Possible complications specific to ORIF include:

  • Infection of the hardware or incision site
  • Nerve damage
  • Damage to tendons or ligaments
  • Damage to blood vessels
  • Bleeding
  • Blood clots
  • Fat embolism
  • Misalignment of the bone
  • Soft tissue irritation from the hardware
  • Failure of the fracture to heal properly leading to further surgery
  • Compartment syndrome - bleeding or swelling due to increased pressure within the muscles resulting in damage to muscles and nerves

We answer some of your most commonly asked questions about ORIF.

How long does an open reduction internal fixation take?

How long your ORIF takes varies considerably depending on the location and severity of your fracture. ORIF surgery can take from one to several hours.

Is ORIF major surgery?

ORIF is a major procedure that is often done as an emergency. It requires a general anaesthetic and the surgery itself can take several hours. It normally requires a hospital stay. Recovery from ORIF can take from a few months to a year.

How long does it take to recover from ORIF surgery?

Recovery from ORIF is different for everyone and depends on the type and severity of your fracture, whether there were any complications during or after your surgery and factors such as your age and general health. It can take anywhere from three months to one year to recover fully from ORIF surgery.

At Circle Health Group we have the experience and expertise to ensure the best possible care and outcome for our patients. As a patient with Circle Health Group, you can expect the highest standards of care including:

  • Flexible appointment times and locations that are convenient for you
  • The freedom to choose which hospital and consultant suit your needs
  • Personalised, consultant-led treatment plans tailored to your individual needs
  • Comfortable and safe private facilities maintained by expert multidisciplinary teams
  • Private ensuite rooms as standard
  • A range of delicious healthy meals
  • Affordable, fixed-price packages with aftercare included
  • Flexible payment options to help you spread the cost of your care

If you would like to see a consultant or learn more about ORIF surgery book your appointment online today or call a member of our team directly on 0141 300 5009.

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