Open Reduction and Internal Fixation Surgery
by Patricia Griffin Kellicker, BSN
An open reduction and internal fixation (ORIF) is a type of surgery used to fix broken bones. This is a 2-part surgery. First, the broken bone is reduced or put back into place. Next, an internal fixation device is placed on the bone. This can be done with screws, plates, rods, or pins that are used to hold the broken bone together.
Reasons for Procedure
This surgery is done to repair fractures that would not heal correctly with casting or splinting alone.
Problems from the procedure are rare, but all procedures have some risk. Problems may include:
Before the procedure, talk to your doctor about ways to manage factors that may increase your risk of complications such as:
Your risk of complications may be increased if you have a history of blood clots.
What to Expect
Prior to Procedure
General anesthesia may be used. It will block any pain and keep you asleep during the surgery. In some cases, a spinal anesthetic, or more rarely a local block, may be used to numb only the area where the surgery will be done. This will depend on where the fracture is located and the time it will take to perform the procedure.
Description of Procedure
Each ORIF surgery differs based on the location and type of fracture. In general, a breathing tube may be placed to help you breathe while you are asleep. Then, the surgeon will wash your skin with an antiseptic and make an incision. Next, the broken bone will be put back into place. Next, a plate with screws, a pin, or a rod that goes through the bone will be attached to the bone to hold the broken parts together. The incision will be closed with staples or stitches. A dressing and/or cast will then be applied.
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Immediately After Procedure
After your surgery, you will be taken to the recovery room for observation. Your blood pressure and breathing will be monitored. Your pulse and the nerves close to the broken bone will also be checked.
How Long Will It Take?
An ORIF surgery can take several hours depending on the fracture and the bone involved.
How Much Will It Hurt?
Anesthesia prevents pain during surgery. Pain and discomfort after the surgery can be managed with medications.
Average Hospital Stay
This procedure is done in a hospital setting. Your length of stay will depend on your surgery. You may be in the hospital for 1-7 days.
At the Hospital
During your stay, the hospital staff will take steps to reduce your chance of infection such as:
There are also steps you can take to reduce your chances of infection such as:
Before you leave the hospital, you will need to arrange for a ride home. Arrange to get help at home from friends and family until you can manage on your own.
When you return home, do the following to help ensure a smooth recovery:
Call Your Doctor
It is important for you to monitor your recovery after you leave the hospital. Alert your doctor to any problems right away. If any of the following occur, call your doctor:
If you think you have an emergency, call for medical help right away.
American Academy of Physical Medicine and Rehabilitation
National Institute of Arthritis and Musculoskeletal and Skin Diseases
The Arthritis Society
Canadian Orthopaedic Association
Fractures (broken bones). Ortho Info—American Academy of Orthopaedic Surgeons website. Available at:
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Updated October 2012. Accessed August 30, 2017.
Elective total hip arthroplasty. EBSCO DynaMed Plus website. Available at: http://www.dynamed... . Updated July 17, 2017. Accessed August 30, 2017.
6/3/2011 EBSCO DynaMed Plus Systematic Literature Surveillance http://www.dynamed... : Mills E, et al. Smoking cessation reduces postoperative complications: a systematic review and meta-analysis. Am J Med. 2011;124(2):144-154.e8.
Last reviewed September 2018 by EBSCO Medical Review Board Warren A. Bodine, DO, CAQSM
Last Updated: 1/24/2014
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