Open reduction internal fixation (ORIF) is a surgical approach that’s used for repairing certain types of bone fractures.
An open reduction is an invasive surgical bone realignment, as opposed to aclosed reductionthat’s done without surgery or an incision. Internal fixation is the surgical insertion of hardware to stabilize and hold the bone in place as it heals.
After ORIF, your recovery will depend on several factors—the severity of your injury, the type of bone involved, your post-operative rehabilitation, and your age.
Open fractures almost always require surgical treatment.Dana Neely / Getty Images
How ORIF Surgery Is Performed
Internal fixation devices include metal plates and screws, stainless steel pins (Kirschner wires, K-wires), andstabilizing rodsthat are placed into the cavity of the bone (intramedullary nails, IM nails).
While some orthopedic implants are designed to stay in the body permanently, sometimes a follow-up surgery may be needed toremove an implantthat was placed to temporarily support the bone during healing. This is sometimes the case with a severe fracture of thetibia(shin bone) orfemur(thigh bone), or when an external device (external fixator) is used.
Repairing Bones and Alignment With an External Fixator
Post-Operative Care
Immobilization leads to muscle atrophy and weakening of ligaments and tendons. Physical therapy is key to post-recovery success.
An Overview of Physical Therapy
Possible Risks
Side effects of ORIF procedures can include bacterial infection, nerve damage, decreased range of motion, and in some cases, arthritis. Shortening of a limb or another deformity may occur—but you could be at risk of these complications if you don’t undergo surgery, as well.
Discuss the risks, benefits, and treatment options with your surgeon to determine the best course of treatment for you.
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2 SourcesVerywell Health uses only high-quality sources, including peer-reviewed studies, to support the facts within our articles. Read oureditorial processto learn more about how we fact-check and keep our content accurate, reliable, and trustworthy.Frangie R.Ankle Fracture: Open Reduction and Internal Fixation.Operative Dictations in Orthopedic Surgery. 2013:231-233. doi:10.1007/978-1-4614-7479-1_64Rasouli MR, Viola J, Maltenfort MG, Shahi A, Parvizi J, Krieg JC.Hardware Removal Due to Infection after Open Reduction and Internal Fixation: Trends and Predictors.Arch Bone Jt Surg. 2015;3(3):184–192Additional ReadingAmerican College of Surgeons. “ACS TQIP: Best Practices in the Management of Orthopedic Trauma.” Chicago, Illinois; 2014.Frangie R.Ankle Fracture: Open Reduction and Internal Fixation.Operative Dictations in Orthopedic Surgery. 2013:231-233. doi:10.1007/978-1-4614-7479-1_64Rasouli MR, Viola J, Maltenfort MG, Shahi A, Parvizi J, Krieg JC.Hardware Removal Due to Infection after Open Reduction and Internal Fixation: Trends and Predictors.Arch Bone Jt Surg. 2015;3(3):184–192
2 Sources
Verywell Health uses only high-quality sources, including peer-reviewed studies, to support the facts within our articles. Read oureditorial processto learn more about how we fact-check and keep our content accurate, reliable, and trustworthy.Frangie R.Ankle Fracture: Open Reduction and Internal Fixation.Operative Dictations in Orthopedic Surgery. 2013:231-233. doi:10.1007/978-1-4614-7479-1_64Rasouli MR, Viola J, Maltenfort MG, Shahi A, Parvizi J, Krieg JC.Hardware Removal Due to Infection after Open Reduction and Internal Fixation: Trends and Predictors.Arch Bone Jt Surg. 2015;3(3):184–192Additional ReadingAmerican College of Surgeons. “ACS TQIP: Best Practices in the Management of Orthopedic Trauma.” Chicago, Illinois; 2014.Frangie R.Ankle Fracture: Open Reduction and Internal Fixation.Operative Dictations in Orthopedic Surgery. 2013:231-233. doi:10.1007/978-1-4614-7479-1_64Rasouli MR, Viola J, Maltenfort MG, Shahi A, Parvizi J, Krieg JC.Hardware Removal Due to Infection after Open Reduction and Internal Fixation: Trends and Predictors.Arch Bone Jt Surg. 2015;3(3):184–192
Verywell Health uses only high-quality sources, including peer-reviewed studies, to support the facts within our articles. Read oureditorial processto learn more about how we fact-check and keep our content accurate, reliable, and trustworthy.
Frangie R.Ankle Fracture: Open Reduction and Internal Fixation.Operative Dictations in Orthopedic Surgery. 2013:231-233. doi:10.1007/978-1-4614-7479-1_64Rasouli MR, Viola J, Maltenfort MG, Shahi A, Parvizi J, Krieg JC.Hardware Removal Due to Infection after Open Reduction and Internal Fixation: Trends and Predictors.Arch Bone Jt Surg. 2015;3(3):184–192
Frangie R.Ankle Fracture: Open Reduction and Internal Fixation.Operative Dictations in Orthopedic Surgery. 2013:231-233. doi:10.1007/978-1-4614-7479-1_64
Rasouli MR, Viola J, Maltenfort MG, Shahi A, Parvizi J, Krieg JC.Hardware Removal Due to Infection after Open Reduction and Internal Fixation: Trends and Predictors.Arch Bone Jt Surg. 2015;3(3):184–192
American College of Surgeons. “ACS TQIP: Best Practices in the Management of Orthopedic Trauma.” Chicago, Illinois; 2014.Frangie R.Ankle Fracture: Open Reduction and Internal Fixation.Operative Dictations in Orthopedic Surgery. 2013:231-233. doi:10.1007/978-1-4614-7479-1_64Rasouli MR, Viola J, Maltenfort MG, Shahi A, Parvizi J, Krieg JC.Hardware Removal Due to Infection after Open Reduction and Internal Fixation: Trends and Predictors.Arch Bone Jt Surg. 2015;3(3):184–192
American College of Surgeons. “ACS TQIP: Best Practices in the Management of Orthopedic Trauma.” Chicago, Illinois; 2014.
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