Open Reduction And Internal Fixation (ORIF)
A Surgical Procedure to Realign and Stabilise Elbow Fractures or Dislocations
ORIF involves repositioning fractured bone fragments and securing them with surgical hardware, such as screws, plates, or wires. This procedure may be required when an elbow fracture cannot heal properly with non-surgical methods.
Common Reasons for Surgery
- Complex fractures where bones are displaced or misaligned.
- Fractures involving multiple bone fragments.
- Elbow instability due to associated ligament injuries.
- Failure of non-surgical treatments, such as immobilisation or casting.
Goals of the Procedure:
- Restore proper alignment and stability to the elbow joint.
- Promote healing and prevent long-term complications, such as stiffness or arthritis.
- Reduce pain and improve the range of motion.
Preparation for Surgery
Preparing for ORIF ensures a smoother surgical process and optimal recovery.
Steps in Preparation:
- Pre-Surgical Consultations:
- Dr Ben McGrath will perform a detailed assessment, including imaging such as X-rays or CT scans, to plan the surgery.
- Pre-Operative Instructions:
- Follow fasting guidelines before surgery.
- Certain medications, such as blood thinners, may need to be paused.
- Lifestyle Adjustments:
- Maintain a healthy weight to support healing.
- Avoid smoking, as it can hinder recovery.
What Happens During the Surgery?
The procedure typically takes 1–3 hours and is performed under general or regional anaesthesia.
Surgical Steps:
- Anaesthesia:
- General or regional anaesthesia ensures comfort during the procedure.
- Reduction and Fixation:
- An incision is made to access the fractured bone.
- The bone fragments are realigned, and surgical hardware is used to stabilise the fracture.
- Closure:
- The incision is closed with sutures or staples and covered with a sterile dressing.
Understanding the Risks
Like any surgery, ORIF carries some risks, which will be discussed during your consultation.
Common Risks:
- Temporary swelling, bruising, or stiffness.
- Pain or discomfort around the surgical site.
Rare but Serious Risks:
- Infection at the incision or around the hardware.
- Blood clots in the arm.
- Nerve or blood vessel injury.
- Delayed bone healing or non-union.
Measures are taken to minimise these risks, including the use of sterile techniques and close monitoring during recovery.
What to Expect After Surgery
Immediate Post-Operative Care:
- Pain management with medications and ice packs.
- The arm may be immobilised in a splint or sling to protect the repair.
Discharge Instructions:
- Keep the surgical site clean and dry.
- Follow all instructions for dressing changes and wound care.
- Avoid lifting or straining the affected arm during the initial healing period.
Rehabilitation and Recovery
A tailored rehabilitation plan is essential for regaining strength and mobility.
Recovery Milestones:
- Weeks 1–6:
- Focus on gentle movements to prevent stiffness while protecting the repair.
- Physiotherapy may begin to maintain range of motion.
- Weeks 6–12:
- Gradual strengthening exercises are introduced under the guidance of a physiotherapist.
- Months 3–6:
- Progressive return to normal activities, such as work or light physical tasks.
Restrictions During Recovery:
- Avoid heavy lifting or high-impact activities until cleared by Dr McGrath.
- Follow physiotherapy recommendations for safe recovery.
Long-Term Outcomes
ORIF is designed to restore elbow function and reduce pain.
Expected Improvements:
- Better alignment and stability of the elbow joint.
- Reduced pain and improved ability to perform daily tasks.
- Prevention of long-term complications, such as chronic stiffness or arthritis.
Maintenance of Results:
- Regular follow-up appointments to monitor healing progress.
- Commitment to physiotherapy and a healthy lifestyle.
Protect the elbow from future injuries by avoiding high-risk activities.