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Open Reduction and Internal Fixation (ORIF)

What is an ORIF?

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


Correction of 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.

Things to know:​

  • You will be discharged in a temporary splint that must be kept clean and dry until you are seen for follow up.
  • You will follow up with us in the office 1-2 days after the procedure. You will be sent for a custom splint that is removable for showering ONLY.
  • After 48 hours you may shower. While showering, you may use soap and water, but be sure to pat the incision dry. 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.
  • It is important to elevate your arm on a couple of pillows to alleviate pain and swelling.
  • We do encourage you to move your unaffected fingers while wearing the splint.
  • Sutures will remain in place for 10-14 days.
  • Typically follow up appointments are scheduled in two-week intervals following surgery, so we can monitor your recovery.
  • You will wear your splint at all times for 4-6 weeks. After 4-6 weeks, 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.
  • After pin removal, you will be referred for Occupational Therapy of the affected hand and wrist.
  • The splint will gradually be discontinued in the weeks to follow as you progress with occupational therapy.  Your lifting restrictions will gradually be increased over the next 2-3 months.

Postoperative restrictions are as follows:

  • NO use of the affected hand.
  • Must wear splint at all times, except while showering.