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Open reduction and internal fixation (ORIF)

What is open reduction and internal fixation (ORIF)?

Open reduction and internal fixation is a surgical procedure for repairing fractured bone using either plates, screws or an intramedullary (IM) rod to stabilise the bone. It is used to repair severely displaced or open bone fractures where the fracture has pierced the skin.

What does ORIF involve?

Open reduction means that the broken bone is realigned during surgery (an “open” procedure) rather than a closed reduction, which is performed without the need for surgery. Internal fixation refers to the components that are used to stabilise the bone (screws, plates or rods).

ORIF is a two-stage process that is carried out in one procedure. The first stage repositions the broken bones and restores their normal alignment. This is called fracture reduction. The second stage – internal fixation – is where the broken bones are held together using metal implants.

The surgeon places the metal implants on the surface of the broken bone or inside it. These hold the bones in place while the fracture heals. Surgery can only be performed when the wound is clean, the pieces of the bone are properly aligned and there is minimal soft tissue or skin damage. The procedure may be delayed if the soft tissues need time to heal.

In some cases, your consultant may use external fixation (metal pins in the bone above and below the fracture site held together with rods like scaffolding) to stabilise the bone while it heals. The pins and screws project out of the skin and are attached to metal or carbon fibre bars. They are removed once the bones are sufficiently healed or are ready to be changed to internal fixation devices.

Open reduction and internal fixation (ORIF)

Shoulder and elbow consultants

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