Which Bone Fractures Commonly Require Open Reduction and Internal Fixation?

An open reduction and internal fixation(ORIF) is a surgical procedure used to fix broken bones that wouldn’t heal properly with basic casting or splinting. It requires two steps: reduction and fixation.

Reducing the Fractured Bone

Reduction, in a medical sense, means putting the bone back in its proper place within the body. Open reduction refers to the need to perform surgery to reset the bone, while a closed reduction can be completed by manipulating the bones externally. Closed reductions are usually performed for hairline fractures while broken bones which are comminuted (broken into multiple fragments, oftentimes including some shattered pieces) and severely displaced (no longer lined up as they naturally belong) are more likely to require an open reduction due to the difficulty of reducing the bone from outside the body.

Fixation of the Fractured Bone

Fixation is the process of installing hardware like screws, rods, pins and plates to hold the bone in place so it doesn’t move before it can heal. These are all installed surgically and remain underneath the skin in an internal fixation procedure.

In our practice, injuries to ankles, wrists, elbows and hips most frequently require ORIF.  These fractures are often caused by falls on unsafe walkways, bicycling collisions, and car crashes.

External fixation may be utilized for more severe fractures and with larger bones, such as fractures of the femur, fibula or tibia. In contrast to the internal fixation procedure, an external fixation involves installation of pins through the skin into the bone which are held in place by an external frame around the wound.

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Jim Dodson
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A Florida injury lawyer, family man and avid cyclist who clients have trusted for over 25 years.