Open Reduction, Internal Fixation (ORIF), Generic

Usually, if bones are broken (fractured) and are out of place, unstable, or may become out of place, surgery is needed. This surgery is called an open reduction and internal fixation (ORIF). Open reduction means that the area of the fracture is opened up so the surgeon can see it. Internal fixation means that screws, pins, or fixation devices are used to hold the bone pieces in place.


  • Allergies.

  • Medicines taken, including herbs, eyedrops, over-the-counter medicines, and creams.

  • Use of steroids (by mouth or creams).

  • Previous problems with anesthetics or numbing medicines.

  • History of bleeding or blood problems.

  • History of blood clots.

  • Possibility of pregnancy, if this applies.

  • Previous surgery.

  • Other health problems.


All surgery is associated with risks. Some of these risks are:

  • Excessive bleeding.

  • Infection.

  • Imperfect results with loss of joint function.


Usually, surgery is performed shortly after the injury. It is important to provide information to your caregiver after your injury.


After surgery, you will be taken to a recovery area where a nurse will monitor your progress. You may have a long, narrow tube(catheter) in the bladder following surgery that helps you pass your water. When awake, stable, taking fluids well, and without complications, you will be returned to your room. You will receive physical therapy and other care. Physical therapy is done until you are doing well and your caregiver feels it is safe for you to go home or to an extended care facility.

Following surgery, the bones may be protected with a cast. The type of casting depends on where the fracture was. Casts are generally left in place for about 5 to 6 weeks. During this time, your caregiver will follow your progress. X-rays may be taken during healing to make sure the bones stay in place.


  • You or your child may resume normal diet and activities as directed or allowed.

  • Put ice on the injured area.

  • Put ice in a plastic bag.

  • Place a towel between the skin and the bag.

  • Leave the ice on for 15-20 minutes at a time, 03-04 times a day, for the first 2 days following surgery.

  • Change bandages (dressings) if necessary or as directed.

  • If given a plaster or fiberglass cast:

  • Do not try to scratch the skin under the cast using sharp or pointed objects.

  • Check the skin around the cast every day. You may put lotion on any red or sore areas.

  • Keep the cast dry and clean.

  • Do not put pressure on any part of the cast or splint until it is fully hardened.

  • The cast or splint can be protected during bathing with a plastic bag. Do not lower the cast or splint into water.

  • Only take over-the-counter or prescription medicines for pain, discomfort, or fever as directed by your caregiver.

  • Use crutches as directed and do not exercise the leg unless instructed.

  • If the bones get out of position (displaced), it may eventually lead to arthritis and lasting disability. Problems can follow even the best of care. Follow the directions of your caregiver.

  • Follow all instructions given by your caregiver, make and keep follow-up appointments, and use crutches as directed.


  • There is redness, swelling, numbness, or increasing pain in the wound.

  • There is pus coming from the wound.

  • You or your child has an oral temperature above 102° F (38.9° C), not controlled by medicine.

  • A bad smell is coming from the wound or dressing.

  • The wound breaks open (edges not staying together) after stitches (sutures) or staples have been removed.

  • The skin or nails below the injury turn blue or gray, or feel cold or numb.

  • There is severe pain under the cast or in the foot.

If there is not a window in the cast for observing the wound, a discharge or minor bleeding may show up as a stain on the outside of the cast. Report these findings to your caregiver.


  • Understand these instructions.

  • Will watch your condition.

  • Will get help right away if you are not doing well or gets worse.