Treating Severe Fractures: ORIF (Open Reduction Internal Fixation) Surgery
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Open Reduction Internal Fixation (ORIF) surgery is a medical procedure used to repair and stabilize severely
broken bones. While some fractures can heal with casting or splinting alone, certain injuries require a more
advanced approach to ensure proper alignment and healing.
As the name suggests, ORIF combines two techniques: open reduction, where the fracture is surgically exposed and
realigned, and internal fixation, which involves using devices like plates, screws, or rods to hold the bone in
place during recovery.
What is Open Reduction Internal Fixation (ORIF) Surgery?
ORIF is an orthopaedic surgery designed for complex fractures that cannot heal properly with conservative treatments. The procedure involves:
Open Reduction: The surgeon makes an incision to access the fracture directly. This allows the bone fragments to be realigned accurately.
Internal Fixation: Once the fracture is aligned, fixation devices such as metal plates, screws, or rods are applied to keep the bone stable.
When is ORIF Surgery Needed?
ORIF surgery is usually indicated in the following situations:
Severely Displaced or Misaligned Fracture: Bones that cannot be realigned externally or would not stay aligned require surgical intervention.
Open or Compound Fracture: Fractures where the bone pierces the skin are at higher risk of infection and need urgent surgical repair.
Unstable Fracture: Certain types of fractures, such as fractures where the bone shatters into multiple pieces, usually require internal fixation for stability.
Associated with Joint Damage: Fractures near or involving joints, such as the hip, ankle, or wrist, often need ORIF to restore function and prevent long-term complications like arthritis.
Unresponsive to Conservative Treatment: If a fracture fails to heal properly with casting, ORIF may be required.
Benefits of ORIF Surgery
ORIF surgery offers several advantages, especially for patients with complex fractures:
Precise Alignment: Open reduction ensures that the bone fragments are perfectly aligned, which is key to proper healing.
Stability and Support: Internal fixation devices provide a good level of stabilization, allowing for earlier mobility and reducing the risk of improper healing.
Faster Recovery Time: By stabilizing the fracture and allowing for physiotherapy to begin sooner, ORIF often results in quicker rehabilitation.
Improved Outcomes: The precise restoration of bone alignment and joint surfaces reduces the risk of long-term complications.
How is ORIF Surgery Performed?
The procedure typically follows these steps:
Anaesthesia: The patient is administered general anaesthesia to ensure patient comfort.
Incision: The surgeon makes an incision over the site of the fracture.
Reduction: Using specialized instruments, the bone is realigned to its natural position.
Internal Fixation: Plates, screws, or rods are secured to the bone to maintain its alignment and stability.
Closure: The incision is carefully closed with sutures or staples.
The duration of the surgery varies depending on the complexity of the fracture and the location of the injury.
Possible Risks and Complications
While ORIF is generally a safe and effective procedure, especially in the hands of an experienced orthopaedic surgeon, it is not without risks. Potential complications include:
Infection: The surgical site or the implanted hardware can become infected.
Hardware Problems: Fixation devices may loosen, break, or irritate surrounding tissues.
Nonunion or Malunion: The bone may fail to heal, or heal improperly.
Nerve or Blood Vessel Injury: Nearby nerves or blood vessels can be damaged during surgery.
Blood Clots: The risk of developing deep vein thrombosis (DVT) increases after major orthopaedic surgery.
However, rest assured that an experienced medical team will be able to minimise those risks and manage any complications that arise.
Recovering from ORIF Surgery
Recovery from ORIF surgery involves a combination of rest, rehabilitation, and medical follow-ups. This includes:
Immobilization: The affected limb may be placed in a cast, splint, or brace to protect the repair during the initial healing stage.
Pain Management: Pain medications are usually prescribed to help manage post-operative discomfort.
Physiotherapy: Rehabilitation exercises following surgery are critical for restoring strength, flexibility, and function.
Monitoring Healing: Regular follow-up appointments with your surgeon is important to ensure the bone is healing as expected.
Most patients recover within 3 to 6 months, though complete healing may take up to a year.
ORIF surgery plays an important role in the treatment of complex fractures. If you suspect that you
have sustained a serious fracture, please seek attention from an orthopaedic specialist immediately.
Dr Wang Lushun is a Senior Consultant Orthopaedic Surgeon with over 18 years of experience. Formerly heading
the Hip and Knee Division at Ng Teng Fong Hospital, Dr Wang is skilled in sports surgery, complex hip and
knee replacements, and minimally invasive surgery, including advanced robotic surgery. Trained in the UK and
France, Dr Wang is dedicated to providing comprehensive and effective orthopaedic care to all his patients.
Trusted
Leadership on Orthopaedic Advisory Boards
Skilful
Double Fellowships at Centres of Excellence
Experienced
Senior Consultant with Over 18 Years of Experience
