About Open Reduction and Internal Fixation (ORIF)

Open reduction and internal fixation surgery is used to fix and/or repair a displaced or unstable fractures or in some cases, a dislocation of a joint using metal screws, plates or wires. These are placed on the bone to keep it in place whilst the bone heals.

In general, ORIF surgery is often an urgent type of surgery for trauma related injuries.

Signs & Symptoms

An ORIF is performed when the injury sustained cannot heal properly with a plaster cast or splint alone, within conservative management measures.

The surgery is usually performed to help reduce pain and restore mobility by helping the bone heal in the right position.

Treatment Options

What happens during surgery?

The first part of the procedure is the open reduction. A/Prof Matthew Lawson-Smith will cut the skin and move the bone back into the correct position. The second part of the surgery is the fixation. A/Prof Matthew Lawson-Smith will insert a metal plate or a wire will then be applied to hold the bone together as it heals. An x-ray is often used during the surgery to check on the alignment and positioning. The incisions made will then be closed with sutures and covered with a bandage.

A splint or plaster cast is then applied to protect the arm while the bone heals.

What happens after surgery?

Dependent on the surgery, you may be required to stay overnight at the hospital, otherwise you are discharged the same day. If you are discharged from hospital on the same day, you will require someone to collect you and stay with you for up to 48 hours post operatively.
All procedures require a plaster cast until you get your splint fitted by a Hand Therapist. This plaster cast is applied at the time of surgery. Some cases require further splinting and hand therapy. Underneath the plaster or splint there are some water-proof dressings. These dressings are to remain on until you see A/Prof Matthew Lawson-Smith or until you see your hand therapist. It is imperative that you keep your wounds clean, dry and sterile.

If you are required to have further splinting, you will be given a referral at the time of discharge to a Hand Therapist. The Hand Therapist may give you some exercises, wound care and a treatment plan in correlation to A/Prof Matthew Lawson-Smith treatments. It is important that you follow this.

A post-operative appointment is normally allocated to you by the rooms. This occurs 2-3 weeks after your procedure. On this day, you will be required to have an x-ray to check your progress.

If you require further analgesia for pain management than initially prescribed on discharge from hospital, you will need to visit your GP.

How long is the recovery period after ORIF surgery?

Generally, recovery takes 3 to 12 months. Complete recovery depends on the type, severity and location of your fracture.

Risks & Concerns

Risks and side effects from ORIF surgery include;

Infection
Scar
Pain
Stiffness
Swelling
Complex Regional Pain Syndrome
Need for further surgery
Failure to relieve symptoms
Worsening pain

Bleeding
Neurovascular deficit or injury
Risk of anaesthetic
Recurrence
Metalwork failure or complications
Blood Clot
Reduced or lost mobility
Arthritis
Tendon or ligament damage

If you experience any problems or have any concerns following your surgery, please do not hesitate to contact the office. A/Prof. Lawson-Smith’s staff will ensure that A/Prof Matthew Lawson-Smith is kept informed and will advise you on the best course of action.

If you are unable to reach the office, please do not hesitate to contact your GP or if it is an emergency, please present to your nearest Emergency Department.