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Open Reduction and Internal Fixation
Open Reduction and Internal Fixation
INTRODUCTION
What is ORIF Surgery?
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 nonweight 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.
TeachMeAnatomy.com
The Shaft
The shaft descends in a slight medial direction. This brings the knees closer
to the bodys center of gravity, increasing stability.
On the posterior surface of the femoral shaft, there are roughened ridges of
bone, these are called the linea aspera (Latin for rough line)
Proximally, the medial border of the linea aspera becomes the pectineal
line. The lateral border becomes the gluteal tuberosity, where the gluteus
maximus attaches.
Distally, the linea aspera widens and forms the floor of
the popliteal fossa, the medial and lateral borders form
the the medial and lateral supracondylar lines. The
medial supracondyle line stops at the adductor
tubercle, where the adductor magnus attaches.
reaction to anesthesia
Risks associated with
ORIF: Nerve damage
that reduces feeling in
the arm or leg
Hardware in the arm
or leg moving out of
place
Pain, swelling, or
trouble moving the arm
or leg
Incomplete healing of
the bone
Increased pressure in
the arm or leg
(compartment
syndrome) which can
damage muscles and
tissue
Blood clot, possibly
traveling to the heart
(pulmonary embolism)
Muscle spasms
If your surgery is urgent, you may not have time to fast beforehand;
make sure to tell your doctor and the anesthesiologist when you last
ate and drank.
Anesthesia
General anesthesia may be used. It will block any pain and keep you asleep
during the surgery. In some cases, a spinal anesthetic, or more rarely a local
block, may be used to numb only the area where the surgery will be done.
This will depend on where the fracture is located and the time it will take to
perform the procedure.
After surgery, patient will be given nutrition through an IV until you are
able to eat and drink.
Patient will be asked to get out of bed and walk 2-3 times a day to
prevent complications.
Patient will begin physical therapy to learn how to move. You will also
be shown exercises to regain muscle strength and range of motion.
Patient will learn how to properly use any assisted devices, such as a a
wheelchair or crutches.
During patient stay, the hospital staff will take steps to reduce your chance
of infection such as:
There are also steps you can take to reduce your chances of infection such
as:
At Home
Complete recovery usually takes 3 to 12 months. How long it takes depends
on how severe your fracture was, and whether nerves and blood vessels
were damaged.
Your doctor may recommend physical therapy during your recovery. A
physical therapist can teach you exercises to help you regain strength and
motion in your limb. These exercises may be necessary for you to be able to
use your arm or leg the way you used to.
Before you leave the hospital, you will need to arrange for a ride home.
Arrange to get help at home from friends and family until you can manage
on your own.
When you return home, do the following to help ensure a smooth recovery:
Elevate the affected limb above the level of your heart for the first 48
hours. You may also be instructed to use ice to reduce swelling.
Ask your doctor when its okay for you to bathe or shower, and when
the dressing will be changed.
If you think you have an emergency, call for medical help right away.