The Wellington Hospital
Wellington Place St John's Wood NW8 9LE London
Fractured bone surgery (ORIF)
Sometimes a broken bone requires more than a cast or splint. In these cases, sterile metal components are inserted to keep fractured bones in place and help them set. This surgery is known as open reduction internal fixation (ORIF).
What is open reduction internal fixation surgery?
Open reduction internal fixation (ORIF) is a surgery to treat bone fractures using support from surgically placed rods and frames. This helps to ensure that the fractured bone heals in the correct alignment. Some of these may be removed after the fracture has healed, while others will remain in place. These components include:
- Plates: these hold pieces of broken bone together and are attached with screws
- Screws: these can hold bones together themselves, or attach to plates and rods
- Rods: these support fractures in longer bones and are inserted through the hollow centre of the bone to stop it rotating or shortening
- Wires and pins: these are used to hold pieces of smaller bone together
- Frames: fitted to the outside of your body, these keep your bone in the correct position
Why do I need ORIF surgery?
ORIF surgery is usually required as an urgent procedure to deal with serious injuries that have resulted in:
- Multiple breaks across the same bone
- Bones that have moved out of position
- Breaks where the bone has gone through the skin.
- Fractures of the arm, leg, wrist, hips, knee, ankle, and shoulder
Benefits of ORIF surgery
Helping your bones heal in good alignment leads to a more straightforward long-term recovery and is the main benefit of ORIF surgery. Other benefits include:
- The best chance of complicated breaks and fractures healing well
- The best chance of bones regrowing back to pre-injury strength
- Reduce pain
- Restore mobility
Need to know
ORIF surgery typically takes place under general anesthetic (as advised by your consultant), so you'll be asleep throughout.
The procedure is split into two halves. The first is the open reduction. Your surgeon will realign the bone fragments, before confirming that they are in the correct position with an X-ray.
Next is the internal fixation. Your surgeon will use the metal hardware (screws, plates, cages, rods, frames etc.) to keep the fractured bone fragments in place. The exact type of hardware will depend on the location and nature of the injury.
The procedure is split into two halves. The first is the open reduction. Your surgeon will realign the bone fragments, before confirming that they are in the correct position with an X-ray.
Next is the internal fixation. Your surgeon will use the metal hardware (screws, plates, cages, rods, frames etc.) to keep the fractured bone fragments in place. The exact type of hardware will depend on the location and nature of the injury.
Patients of ORIF surgery should expect pain and swelling around the operated area for a few days after the operation.
Your consultant will work closely with you to prescribe medication to help with pain management, but you should expect to feel some mild pain for up to six weeks after surgery.
Throughout your recovery, our team will work to ensure you are as comfortable as possible.
Your consultant will work closely with you to prescribe medication to help with pain management, but you should expect to feel some mild pain for up to six weeks after surgery.
Throughout your recovery, our team will work to ensure you are as comfortable as possible.
In most cases the hardware used to correct and repair broken bones in an ORIF procedure are removed once your consultant is confident that the bone has healed well enough.
There are some instances where wires or plates might have to be left in permanently. This depends on what type of fracture or break you have.
There are some instances where wires or plates might have to be left in permanently. This depends on what type of fracture or break you have.
If your ORIF surgery is for a fracture or break to your leg or foot, there will typically be a six to eight-week period following surgery where you’ll be advised not to walk. This is to prevent the healing bones from having to bear weight and avoid further injury.
After this time, you’ll be able to start limited walking with a special boot. This will coincide with a physical therapy programme to help your recovery.
After this time, you’ll be able to start limited walking with a special boot. This will coincide with a physical therapy programme to help your recovery.
Often, this procedure is carried out as an emergency, so preparation is difficult. However, your consultant will take time to explain the procedure to you and answer any questions you may have.
Because you'll be under general anesthetic during the operation, they'll let you know how long you should avoid eating and drinking before surgery.
As with all procedures, there may be some risks and side effects involved. Your consultant will explain these to you.
Because you'll be under general anesthetic during the operation, they'll let you know how long you should avoid eating and drinking before surgery.
As with all procedures, there may be some risks and side effects involved. Your consultant will explain these to you.
After your surgery, your consultant will take an X-ray of your joints to make sure they are correctly aligned and the procedure was a success. Once you have recovered from surgery, a member of the physiotherapy team will work with you to help restore strength and range of motion in the affected area. The full recovery time can vary and is difficult to determine, but can be anywhere between three months to a year.
You may need further physiotherapy as an outpatient, along with pain medication and rest. Any return to work is decided on a case-by-case basis and will depend on the nature of your job and the nature of your injury.
You may need further physiotherapy as an outpatient, along with pain medication and rest. Any return to work is decided on a case-by-case basis and will depend on the nature of your job and the nature of your injury.
This content is intended for general information only and does not replace the need for personal advice from a qualified health professional.
Our fracture surgery locations
London Bridge Hospital
27 Tooley Street SE1 2PR London
The Lister Hospital
Chelsea Bridge Road SW1W 8RH London
The Princess Grace Hospital
42-52 Nottingham Place W1U 5NY London
The Harborne Hospital
Mindelsohn Way B15 2FQ Birmingham