Having Elbow Fracture Open Reduction and Internal Fixation (ORIF)

ORIF is a type of treatment to fix a broken bone. It puts the pieces of a broken bone back together so they can heal. Open reduction means the bones are put back in place during a surgery. Internal fixation means that special hardware is used to hold the bone pieces together. This helps the bones heal correctly. The procedure is done by an orthopedic surgeon. This is a doctor with special training in treating bone, joint, and muscle problems.

What to tell your healthcare provider

Tell your healthcare provider about all the medicines you take. This includes over-the-counter medicines, such as ibuprofen. It also includes vitamins, herbs, and other supplements. Tell the healthcare provider the last time you had something to eat or drink. And tell your provider if you:

• Have had any recent changes in your health, such as an infection or fever

• Are sensitive or allergic to any medicines, latex, or tape

• Are sensitive or allergic to anesthesia, the numbing medicines used to put you to sleep during surgery or to numb the surgery area

• Are pregnant or think you may be pregnant

Tests before your surgery

You may have an X-ray or a CT scan to look at your arm.

Getting ready for your surgery

ORIF is sometimes done as emergency surgery after an accident or injury. Before this procedure, a provider will ask about your health history and give you a physical exam.

In some cases, elbow fracture ORIF is planned. Talk with your healthcare provider about how to get ready for surgery. You may need to stop taking some medicines before the procedure, such as blood thinners and aspirin. If you smoke, you may need to stop before your surgery. Smoking can delay healing. Talk with your provider if you need help to stop smoking.

Also, make sure to:

• Ask a family member or friend to take you home from the hospital. You can't drive yourself.

• Plan some changes at home to help you recover. You may need help at home after the surgery.

• Follow any directions you’re given for not eating or drinking before the surgery.

• Follow all other instructions from your healthcare provider.

You'll be asked to sign a consent form that gives your permission to do the surgery. Read the form carefully. Ask questions if something isn't clear.

On the day of surgery

Your surgeon will explain the details of your surgery. These details will depend on where your injury is and how bad it is. An orthopedic surgeon with a team of specialized nurses will do the procedure. The preparation and surgery may take a couple of hours. In general, you can expect the following:

• You'll likely have general anesthesia. This will prevent pain and make you sleep through the surgery. Or you may have local anesthesia to numb the area and medicine to help you relax and sleep through the surgery.

• A healthcare provider will watch your vital signs, like your heart rate and blood pressure, during the surgery.

• After cleaning the skin, your surgeon will make a cut (incision) through the skin and muscle around your elbow.

• The surgeon will put the pieces of your broken elbow bones back into place (reduction).

• The surgeon will secure the pieces of the broken bones to each other (fixation). They may use screws, metal plates, wires, or pins.

• The surgeon will make other repairs to the area as needed.

• The surgeon will close the layers of muscle and skin around your elbow with stitches (sutures) or staples.

After your surgery

Talk with your surgeon about what you can expect after your surgery. You may be able to go home the same day. Or you may need to stay in the hospital overnight. Before leaving the hospital, you'll likely have X-rays taken of your arm. This is to check the repair.

You'll have some pain after surgery. Your healthcare provider will tell you what pain medicine you can take to help reduce the pain. You may be instructed not to take certain over-the-counter medicines for pain. Some of these may interfere with bone healing. You can also use ice packs to help reduce pain and swelling.

Your elbow may be put in a splint or cast for a period of time after surgery.

• Physical therapy. Most patients will begin exercises to improve elbow and forearm motion shortly after surgery, sometimes as early as the next day. It is extremely important to perform the exercises as often as directed. The exercises will make a difference only if they are done regularly.

• Restrictions. Depending on the severity of your fracture, your healthcare provider may allow you to use your arm to feed, bathe, and dress yourself. However, you may be restricted from lifting, pushing, or pulling activities (including opening or closing doors) with your injured arm for 6 to 12 weeks.

Your surgeon may also tell you to eat foods high in calcium and vitamin D to help with bone healing. You may need to take medicine called a blood thinner for a little while after your surgery. Blood thinners stop blood from clotting or clumping together. Follow all of your healthcare provider’s instructions carefully.

Follow-up care

Make sure to go to all of your follow-up visits. You may need to have your stitches or staples removed a week or so after your surgery.

You may have physical therapy to improve the strength and movement of your arm. The therapy may include treatments and exercises. Physical therapy improves your chances of a full recovery. Most people are able to return to their normal activities within a few months.

When to call your healthcare provider

Call your healthcare provider if you have any of the following:

• Fever of 100.4°F (38°C) or higher, or as directed by your provider

• Chills

• Redness, swelling, or fluid leaking from your incision that gets worse

• Pain in your arm that gets worse

• Loss of feeling in your arm or hand