Description: An Open Reduction Internal Fixation (ORIF) refers to a surgical procedure to fix a severe bone fracture, or break.

It involves the implementation of implants to guide the healing process of a bone, as well as the open reduction, or setting, of the bone itself. "Open Reduction" means surgery is needed to realign the bone fracture into the normal position. It also refers to open surgery - to set bones, as is necessary for some fractures. "Internal Fixation" refers to the steel rods, screws, or plates used to keep the bone fracture stable in order to heal the right way and to help prevent infection. It also refers to fixation of screws and/or plates to enable or facilitate healing. Open Reduction Internal Fixation can also refer to the surgical repair of a joint, such as a hip or knee replacement. Open Reduction Internal Fixation techniques are often used in cases involving serious fractures such as comminuted or displaced fractures. The surgical procedure is performed by a doctor who specializes in orthopedics, which is a branch of medicine concerning the musculoskeletal structure of the body. Under general anesthesia, an incision is made at the site of the break or injury, and the fracture is carefully re-aligned or the joint replaced. The hardware is installed, and the incision is closed with staples or stitches. The steel rods, screws, or plates can be permanent, or temporary and removed when healing takes place. Anatomy of Affected Part: FEMORAL FRACTURE (as an example of the many types of fracture)

The symptoms, treatment, and possible complications of a fracture of the femur depend on whether the bone has broken across its neck or across the shaft. This type of fracture, often called a broken hip, is commonly in elderly people, especially in women suffering from osteoporosis and is usually associated with a fall. This incidence of this type of fracture doubles approximately every seven years after the age of 65, so that by the age of 90 one woman in four has suffered this type of fracture. In a fracture of the neck of the femur, the broken bone ends are often considerably displaced; in such cases there is usually severe pain in the hip and groin (made worse by movement) and the leg cannot bear any weight. Occasionally, the broken ends of the

bone become impacted (wedged together). In this case there is less pain and walking is often still possible, which may delay reporting of the injury and detection of the fracture. Post-Operative Nursing Management: Physical therapy is also an important part of the recovery process after

an open reduction internal fixation. Since the part of the body that has been injured is usually held still or immobilized for a long period of time, the muscles, tendons, and ligaments can become weak. Physical therapy helps to restore the strength, range of motion, and endurance of the affected area. It can also help with pain management. Physical therapy can consist of exercises, hot or cold packs, ultrasound, and nerve stimulation, or a combination of treatments. Risks and complications can include bacterial colonization of the bone, infection, stiffness and loss of range of motion, non-union, malunion, damage with to the muscles, and nerve damage and

palsy, arthritis, tendonitis,

chronic pain associated

plates,

screws,

pins, compartment

syndrome, deformity, audible popping and snapping, and possible future surgeries to remove the hardware. Complications of ORIF can include infection, swelling, and movement of the installed hardware. The recovery process can take months, because bones grow slowly. Other factors that can affect recovery are the location and severity of the break, the age of the person, and the type of bone broken. Recovery from a bone fracture after an open reduction internal fixation can be quite painful, and pain management becomes a concern. Commonly, acetaminophen with codeine is prescribed, as research has shown ibuprofen or other non-steroid anti-inflammatory drugs (NSAIDs) may slow down or inhibit the rate of healing. It is important to take the drugs as prescribed to help manage the pain cycle.

Instruments Specific to the Operation:

Instrument type/name: Bone Screws Raw material: Bar stock certified implant stainless steel Main function: To fasten together fractured bone segments and to affix bone plates. Where used mostly: Orthopedic surgery (fractures) Important features: They are manufactured in accordance with the International Organization for Standardization (ISO). Screws come in various sizes and types, and are designed for bones of different size, type and quality. Useful hints in usage: Screw sizes are determined by the outside diameter of their threaded section. It is very important to chose the proper type of screw for the procedure. Screws are not self-tapping and require that a thread be cut before insertion. Washers are available to prevent screw heads from sinking into bone. An internal fixation device should never be reused. Instrument subtypes: Cortical Bone Screws; Cancellous Bone Screws; Malleolar Bone Screws

Instrument type/name: Bone Plates Raw material: Bar stock certified implant stainless steel Main function: To fasten together fractured bone segments Where used mostly: Orthopedic surgery (fractures) Important product features: They are manufactured in accordance with the International Organization for Standardization (ISO). Plates come in various sizes and types, designed for bones of different size, type and quality, and require a variety of screw sizes. Useful hints in usage: Plate names generally derive from the plate design or bone for which it is designed. Plate holes are designed to allow screw insertions at varying angles. An internal fixation device should never be reused. Instrument type/name: Wire and Pin Management Instruments Raw material: Forgings from stainless steel Surface: Silk matte satin finish Main function: To assist the surgeon in the implantation and removal of pins and wires. To store, pull, twist, cut and tighten wires, pins and rods. Where used mostly: Orthopedic surgery (fractures) Instrument subtypes: K-Wire Dispensers; Plate Cutters; Wire Drivers and Benders; Pliers; Hand Drills; Plug Cutters; Chucks; Wire Twisters; Wire and Pin Cutters; Wire Tighteners; Cable Cutters; Wire Guide

femur
The thigh bone, extending from the hip to the knee of four- and two-legged vertebrates, including humans. The femur is the largest, longest, and strongest bone of the humanskeleton. Its rounded, smooth head fits into a socket in thepelvis called the acetabulum to form the hip joint (an example of a ball-and-socket joint). The head of the femur is joined to the bone shaft by a narrow piece of bone known as the neck of the femur. The neck of the femur is a point of structural weakness and a common fracture site. The lower end of the femur hinges with the tibia (shinbone) to form the knee joint.

The femur can be felt through the skin at two sites. At the lower end, the bone is enlarged to form two lumps called the condyles that distribute the weight-bearing load on the knee joint. On the outer side of the upper end of the femur is a protuberance called the greater trochanter. The gluteus and psoas muscles are inserted on the greater and lesser trochanter, respectively. The lateral and medial epicondyles articulate with the tibia and the trochlear groove accommodates the patella (kneecap). The term "femoral" means relating to the femur or to the thigh, as in femoral artery or femoral nerve.