Open Reduction and Internal Fixation (ORIF)

Open Reduction and Internal Fixation (ORIF) involves fixing severely broken bones and placing them back together using pins, plates, or screws. 

Surgery to correct a misalignment of the broken bones involves making an incision and aligning the broken bones back into place. A pin is placed through the tip of the affected finger for finger fractures, or in the back of the affected hand for metacarpal fractures. In some instances, when bones can be easily manipulated to correct alignment, Closed Reduction and Internal Fixation may be done and no incision will be made in affected finger/hand. This surgery is performed on an outpatient basis meaning you will be able to go home that day. You will be discharged in a temporary splint that must be kept clean and dry until you are seen for follow up appointment with your surgeon, usually the next day. It is important to elevate your arm on a couple of pillows to alleviate pain and swelling. 

At your follow up appointment, we will write you a prescription for a splint. You will need to wear the splint at all times, except when showering. You are able to shower 48 hours after surgery; however, it is important that you do not submerge your surgical incision in water (i.e. no bath tubs, swimming pools, washing dishes, etc.). While showering, it is important you do not use your hand/arm. After showering, pat incision dry and replace splint. We do encourage you to move your unaffected fingers while wearing the splint.

Sutures will be removed 10-14 days after surgery. After suture removal, splint will continue to be worn until pin is removed typically 4-6 weeks post op (6 weeks in adults, and 4 weeks in children). Pin is removed easily in our office, and does not require another surgery. If plates or screws are used to fix the fracture they will remain in place indefinitely, unless causing pain for patient. This is rare. If plates and screws require removal in the future, this will require an additional surgery. Typically follow up appointments are scheduled at two-week intervals after surgery so we can monitor your recovery. You will be placed under a restriction of no using the affected hand for a minimum of 6 weeks; patient should be able to do desk work. Occupational therapy will most likely begin 4-6 weeks after surgery, as indicated by your surgeon. The splint will gradually be discontinued in the weeks to follow as you progress with occupational therapy and your lifting restrictions will gradually be increased over the next 2-3 months, as indicated by your healthcare provider. 

You may resume your regular diet after surgery; however, you should start slow. It is a good idea to start with things like toast, Jell-O, crackers, and soup to see how your stomach tolerates food after anesthesia. Drink plenty of fluids such as water or Gatorade and limit your intake of sodas, coffee and other caffeinated beverages.  

We will send you home with a prescription for an antibiotic and a pain medication. It is important to take your antibiotic and pain medication with food to prevent nausea (unless you are instructed otherwise). Do not take your pain medication and antibiotic at the same time as this may upset your stomach; separate them by an hour or two. You cannot drive while taking pain medication.

Should you develop any of the following signs and or symptoms of possible infection, call our office immediately:

  1. Fever over 100.3
  2. Chills or night sweats
  3. Unusual swelling, redness, or warmth to your incision site
  4. Purulent drainage from incision site.

Please do not hesitate to call our office with any concerns or questions you may have.

Please remember the above instructions are only a guide. Always listen to the instructions given by your healthcare provider and follow those if in conflict with any listed above

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