Open reduction internal fixation (ORIF)

What is ORIF?

Open reduction internal fixation or ORIF is a method of surgically repairing a fractured bone. Generally, this involves either the use of plates and screws or an intramedullary (IM) rod to stabilise the bone.

How is ORIF carried out?

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. X-rays are used 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 help of imaging (X-rays and MRI scanning) to ensure that the bone is healing correctly.

Benefits of ORIF

Successful surgery usually enables patients to return to normal daily activities.  It can avoid the need for protracted periods of time in plaster. For certain complex fractures it provides the best possible outcome, and is necessary above and beyond plaster treatment.

Possible complications

There are always risks with surgery, such as infection or bleeding too much.

1. General complications of any operation

• Pain
• Bleeding
• Infection in the surgical wound
• Unsightly scarring
• Blood clots
• Difficulty passing urine
• Chest infection
• Heart attack or stroke

2. Specific complications of this operation

• Nerves, blood vessels, ligaments, muscles, and bones may be damaged
• Stiffness, numbness and weakness in treated joints
• Pain
• Movement problems
• Blood clots
• Stroke