Having Elbow Fracture Open Reduction and Internal Fixation (ORIF)
Open reduction and internal fixation (ORIF) is a type of treatment to fix a broken bone. It puts the pieces of a broken bone back together so they can heal. Open reduction means the bones are put back in place during a surgery. Internal fixation means that special hardware is used to hold the bone pieces together. This helps the bones heal correctly. The procedure is done by an orthopedic surgeon. This is a doctor with special training in treating bone, joint, and muscle problems.
What to tell your healthcare provider
Tell your healthcare provider about all the medicines you take. This includes over-the-counter medicines such as ibuprofen. It also includes vitamins, herbs, and other supplements. Also, tell the provider the last time you had something to eat or drink. And tell your healthcare provider if you:
Have had any recent changes in your health, such as an infection or fever
Are sensitive or allergic to any medicines, latex, or tape
Are sensitive or allergic to anesthesia, the numbing medicines used to put you to sleep during surgery or to numb the surgery area
Are pregnant or think you may be pregnant
Tests before your surgery
You may have an X-ray or a CT scan to look at your arm.
Getting ready for your surgery
ORIF is sometimes done as emergency surgery after an accident or injury. Before this procedure, a healthcare provider will ask about your health history and give you a physical exam.
In some cases, elbow fracture ORIF is planned. Talk with your healthcare provider about how to prepare for your surgery. You may need to stop taking some medicines before the procedure, such as blood thinners and aspirin. If you smoke, you may need to stop before your surgery. Smoking can delay healing. Talk with your healthcare provider if you need help to stop smoking.
Also, make sure to:
Ask a family member or friend to take you home from the hospital. You cannot drive yourself.
Plan some changes at home to help you recover. You may need help at home after the surgery.
Follow any directions you’re given for not eating or drinking before the surgery.
Follow all other instructions from your healthcare provider.
You may be asked to sign a consent form that gives your permission to do the surgery. Read the form carefully. Ask questions if something is not clear.
On the day of surgery
Your surgeon will explain the details of your surgery. These details will depend on where your injury is and how bad it is. An orthopedic surgeon with a team of specialized nurses will do the surgery. The preparation and surgery may take a couple of hours. In general, you can expect the following:
You will likely have general anesthesia.This will prevent pain and make you sleep through the surgery. Or you may have local anesthesia to numb the area and medicine to help you relax and sleep through the surgery.
A healthcare provider watches your vital signs, like your heart rate and blood pressure, during the surgery.
After cleaning the skin, your surgeon will make a cut (incision) through the skin and muscle around your elbow.
The surgeon will put the pieces of your broken elbow bones back into place (reduction).
The surgeon will secure the pieces of the broken bones to each other (fixation). He or she may use screws, metal plates, wires, or pins.
The surgeon will make other repairs to the area as needed.
The surgeon will close the layers of muscle and skin around your elbow with stitches (sutures) or staples.
After your surgery
Talk to your surgeon about what you can expect after your surgery. You may be able to go home the same day. Or you may need to stay in the hospital overnight. Before leaving the hospital, you will likely have X-rays taken of your arm. This is to check the repair.
You will have some pain after the surgery. Your doctor will tell you what pain medicine you can take to help reduce the pain. Don't take certain over-the-counter medicines for pain as instructed. Some of these may interfere with bone healing. You can also use ice packs to help lessen pain and swelling.
For a while after your surgery, you must be careful not to move your arm at all. Often, this means you'll need to wear a splint for several weeks. A splint will help you keep your arm from moving. Make sure keep your splint does not get wet. Your healthcare provider will tell you when it is safe to move your arm again.
Your surgeon may also tell you to eat foods high in calcium and vitamin D to help with bone healing. You may need to take medicine called a blood thinner for a little while after your surgery. Blood thinners stop blood from clotting or clumping together. Follow all your doctor’s instructions carefully.
Make sure to go to all of your follow-up visits. You may need to have your stitches or staples removed a week or so after your surgery.
You may have physical therapy to improve the strength and movement of your arm. The therapy may include treatments and exercises. Physical therapy improves your chances of a full recovery. Most people are able to return to their normal activities within a few months.
When to call your healthcare provider
Call your healthcare provider if you have any of the following:
Fever of 100.4°F (38°C) or higher, or as directed by your provider
Redness, swelling, or fluid leaking from your incision that gets worse
Pain in your arm that gets worse
Loss of feeling in your arm or hand
April 27, 2018
Babhulkar S, Babhulkar S. Controversies in the management of intra-articular fractures of distal humerus in adults. Indian J Orthop. 2011;45(3):216-25., Giannicola G, Sacchetti FM, Greco A, et al. Open reduction and internal fixation combined with hinged elbow fixator in capeitellum and trochlea fractures. Acta Orthopaedica. 2010;81(2):230-35., Mardanpour K, Rahbar M. Open reduction and internal fixation of intraarticular fractures of the humerus: evaluation of 33 cases. Trauma Monthly. 2013;17(4):396-400., Slabaugh M. Radial head and neck fractures in adults. UpToDate.
Joseph, Thomas N., MD,MMI board-certified, academically affiliated clinician,Turley, Ray, BSN, MSN