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What Is ORIF Surgery?

Medically Reviewed by Dan Brennan, MD on May 20, 2021

ORIF stands for open reduction and internal fixation. It's a type of surgery that is used to repair broken bones that need to be put back together. During the surgery, some form of hardware is used to hold the bone together so it can heal. 

When Do You Need ORIF Surgery?

ORIF surgery is only needed for severe fractures. It's often performed as emergency surgery. If your bone is in pieces, it may need to be repositioned and held in place with screws or plates until it heals. This surgery is done by an orthopedic surgeon, a doctor with specialized training in treating bone, joint, and muscle problems. 

How Is ORIF Surgery Performed?

During the surgery, your bone fragments will be repositioned into normal alignment. The bone fragments are held together with hardware such as plates, screws, or wires. The implants are made from stainless steel or titanium because these are strong and durable metals. Here's a look at the types of hardware used for ORIF surgery.

Screws. Screws are the most common type of hardware used in ORIF surgery. The types of screws used to repair the bone depend on the kind of fracture you have, the size of the bone in question, and where the screws will be placed. They can be used alone or with other types of hardware. Once your fracture is healed, the screws may be left inside of you or removed.  

Plates. Plates are like internal splints that hold your bone in place. Your doctor will use screws to attach the plates to your bones. After you've healed, the plates may be removed or left in place.   

Rods or nails. If you've fractured a long bone, your doctor may use a rod or nail inserted through the center of your bone to hold it in place. Screws at each end of the rod keep the bones from rotating or shifting and hold the rod in place. This type of treatment is commonly used for fractures of the thigh bone or shin bone. Once your fracture has healed, the rods or nails can be removed or left in place.    

Pins or wires. If your bone broke into small pieces, your doctor may use wires to pin it back together. Wires and pins are often used with other types of internal fixation, but they can also be used alone. Sometimes, they're the only fixation used to fix small bones such as those in the hands.

Wires are usually removed after your fracture heals. However, sometimes they're left in place.      

External fixators. An external fixator can be used as a temporary frame to hold the bones together when the skin and muscle have been injured. With an external fixator, metal pins or screws are placed into the bone through small incisions in the skin and muscle. The pins or screws are attached to a bar on the outside of the skin.     

An external fixator is often used as a temporary treatment when you have multiple injuries but aren't stable or healthy enough for surgery. There are times when an external fixator is used until your fracture is completely healed.  

Possible Complications of ORIF Surgery

All surgeries have risks of complications. Some possible complications that can develop after ORIF surgery include: 

How Long Does it Take to Recover From ORIF Surgery?

Complete recovery from ORIF surgery can take anywhere from three to 12 months, depending on what bone you broke and how severe the break was. You may need physical therapy after your surgery to help you regain full use of your limb. Here are some tips for taking care of yourself at home once your surgery is completed.

Elevate your injured limb. For the first 48 hours, try to keep your limb elevated above the level of your heart. You may also use ice packs to reduce the swelling.

Try to stay on top of your pain. Your doctor will give you instructions about pain medicine. Make sure you have it before you go home and use it as instructed. If you're having pain that isn't controlled by the pain medicine, call your doctor.   

Cover your incision and keep it clean. Follow your doctor's instructions about showering and changing your bandages.    

Don't put any pressure on your injured limb. Use crutches, a wheelchair, or a sling if your doctor sent you home with them. In the beginning, it's important not to use your injured limb even to balance or reposition yourself. Your doctor will give you instructions about when and how to start using your limb again.  

Show Sources

SOURCES:

Beth Israel Lahey Health Winchester Hospital: "Open Reduction and Internal Fixation Surgery."

Intermountain Healthcare: "Open Reduction and Internal Fixation (ORIF)."

OrthoInfo: "Internal Fixation for Fractures."

Saint Luke's: "Understanding Tibia/Fibula Fracture Open Reduction and Internal Fixation (ORIF)."

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