ORIF O.R.I.F. is an abbreviation for Open Reduction Internal Fixation.

Open reduction internal fixation is a method of surgically repairing a fractured bone. Generally, this involves either the use of plates and screws or an intramedullary (IM) rod to stabilize the bone. If you are having a broken bone treated by ORIF, you will be taken to the operating room, given anesthesia so that you will not feel the surgery, and have your bones repaired by an orthopedic surgeon. Methods of ORIF 1. Intramedullary (IM) rods are used to align and stabilize fractures. IM rods are inserted into the bone marrow canal in the center of the long bones of the extremities (e.g. femur or tibia). One of the significant advantages of IM rods over other methods of fixation is IM rods share the load with the bone, rather that entirely support the bone. Because of this, patients are able to use the extremity more quickly. IM rods cannot be used for all fractures, and there are often associated complaints of pain and other symptoms at the site the IM rods are inserted. For this reason, a second operation may be needed to remove the IM device if you have painful symptoms. Otherwise, the IM nail can usually stay inside your bone forever. 2. Using of plates and screws which will serves as a support to the bones due to the healing process and can be removed if the client wants to. 3. External fixation is a method of immobilizing bones to allow a fracture to heal. External fixation is accomplished by placing pins or screws into the bone on both sides of the fracture. The pins are then secured together outside the skin with clamps and rods. The clamps and rods are known as the "external frame." Some of the advantages of external fixation are that it is quickly and easily applied. The risk of infection at the site of the fracture is minimal, but there is a risk of infection where the pins are inserted from the skin into the bone. Indications of ORIF Absolute 1. Unable to obtain an adequate reduction 2. Displaced intra-articular fractures 3. Certain types of displaced epiphyseal fractures 4. Major avulsion fractures where there is loss of function of a joint or muscle group 5. Non-unions 6. Re- implantations of limbs or extremities Relative 1. Delayed unions 2. Multiple fractures to assist in care and general management 3. Unable to maintain a reduction

4. Pathological fractures 5. To assist in nursing care 6. To reduce morbidity due to prolonged immobilisation 7. For fractures in which closed methods are known to be ineffective Procedure of ORIF 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 non-weight 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. Recovery rate and Process of ORIF Recovery from a bone fracture after an open reduction internal fixation can be quite painful, and pain management becomes a concern. Commonly, acetaminophen with codeine is prescribed, as research has shown ibuprofen or other non-steroid anti-inflammatory drugs (NSAIDs) may slow down or inhibit the rate of healing. It is important to take the drugs as prescribed to help manage the pain cycle. Physical therapy is also an important part of the recovery process after an open reduction internal fixation. Since the part of the body that has been injured is usually held still or immobilized for a long period of time, the muscles, tendons, and ligaments can become weak. Physical therapy helps to restore the strength, range of motion, and endurance of the affected area. It can also help with pain management. Physical therapy can consist of exercises, hot or cold packs, ultrasound, and nerve stimulation, or a combination of treatments. Complications Complications of ORIF can include infection, swelling, and movement of the installed hardware. The recovery process can take months, because bones grow slowly. Other factors that can affect recovery are the location and severity of the break, the age of the person, and the type of bone broken.