Definition: Open Reduction and internal fixation (ORIF) is a surgery to repair a broken bone.

Open reductions means the surgeon makes an incision to reach the bones and move them back
into their normal position. Internal fixation means metal screws, plates, sutures, or rods are
placed on the bone to keep it in place while it heals.

Purpose
• To decrease pain and help your broken arm or leg heal correctly
• Restore the bone to its normal function
• Prevent further injury

Instruments
• Towel Clip
• Kidney Basin
• Scalpel
• Blade
• Cautery Tip
• Mosquito clamp
• Allis
• Needle holder
• Army Navy
• Mayo scissors
• Metzembaum
• Sponges
• Abdominal pack
• Screws, Rods, Plates
• Drill

Procedure
1. Anesthesia: An anesthesia provider will discuss pain control with the patient. Patient will be
given general anesthesia so you sleep through the procedure.
2. Incision: The surgeon will make an incision in the skin over the bone.
3. Moving the bone into place: The surgeon will move the bone into the correct position. Metal
plates, rods, sutures, and screw will then be applied to hold the bone together as it heals. An
x-ray may be taken after the devices are attached.
4. Closing the incision: The incision will be closed with stitches or staples and covered with a
bandage. A cast or splint will be put on to protect the repair as it heals.
5. Recovery: After the surgery, the patient will be taken t a recovery area to be monitored until
they are awake and doing well. The circulation, sensation, and movement will be checked
often.
Nursing Responsibilities
Pre-op
- Let patient sign the consent
- Reduce the anxiety of the patient
- Take vital signs of patient
- Put patient on NPO
- Provide for physical safety
- Establish intravenous line
Intra-op
- Maintenance of safety
- Maintains aseptic, controlled environment
- Position client
- Drape patient
- Ensure that the sponge, instrument,and needle counts are correct
- Calculate effects patient of excessive fluid loss or gain
- Report changes in vital signs
Post-op
- Monitor vital signs frequently
- Monitor pain level and administer prescribed analgesics
- Keep patient warm
- Elevate the affected limb above heart level for the first 48 hours
- Keep incision clean and covered
- Check site if it is bleeding
- Monitor skin integrity
- Let patient know not to put any weight or pressure on the healing limb
- Let patient know that he/she has maintain bed rest
- Let patient know to apply ice to cast
- Assist patient with passive and active ROM exercises

Surgical Position : Supine position