Open Reduction And Internal Fixation Of A Leg Fracture

WHAT YOU SHOULD KNOW:

Open reduction and internal fixation (ORIF) is surgery to fix a fractured (broken) bone in your leg. Orthopedic hardware (screws or plates) is used to hold the broken bone together while it heals.


CARE AGREEMENT:

You have the right to help plan your care. Learn about your health condition and how it may be treated. Discuss treatment options with your caregivers to decide what care you want to receive. You always have the right to refuse treatment.

RISKS:

  • You may bleed more than expected or get an infection. After surgery, your leg may not heal correctly. The nerves or blood vessels near the bone may have been damaged when your leg was broken. You may get a blood clot in your leg or arm. This can cause pain and swelling, and it can stop blood from flowing where it needs to go in your body. The blood clot can break loose and travel to your lungs. A blood clot in your lungs can cause chest pain and trouble breathing. You are also at risk of developing a fat emboli. This is when fat is forced out of the inside of the bone (bone marrow) and can block a blood vessel. These problems can be life-threatening.

  • If you do not have surgery, your broken leg may not heal right. You could also get a serious infection.

WHILE YOU ARE HERE:

Before surgery:

  • Informed consent is a legal document that explains the tests, treatments, or procedures that you may need. Informed consent means you understand what will be done and can make decisions about what you want. You give your permission when you sign the consent form. You can have someone sign this form for you if you are not able to sign it. You have the right to understand your medical care in words you know. Before you sign the consent form, understand the risks and benefits of what will be done. Make sure all your questions are answered.

  • An IV is a small tube placed in your vein that is used to give you medicine or liquids.

  • Vital signs: Caregivers will check your blood pressure, heart rate, breathing rate, and temperature. They will also ask about your pain. These vital signs give caregivers information about your current health.

  • Heart monitor: Sticky pads placed on your skin record your heart's electrical activity.

  • Anesthesia:

    • Regional anesthesia: Medicine is injected to numb the body area where the surgery or procedure will be done. You will remain awake during the surgery or procedure.

    • General anesthesia will keep you asleep and free from pain during surgery. Anesthesia may be given through your IV. You may instead breathe it in through a mask or a tube placed down your throat. The tube may cause you to have a sore throat when you wake up.

During your surgery:

  • An incision is made in the skin over the broken bone. Your caregiver will put the broken bone pieces back together. Metal pins, screws, rods, or plates are screwed into the side of the broken bones to hold them together while they heal. Your caregiver may take some bone from your hip. The bone can be used to help fix your broken leg.

  • X-rays may be taken during surgery to help caregivers make sure your broken bone is straight. The x-rays also tell your caregivers if the pins, plates, and screws are placed correctly. Caregivers may put a hinge called an external fixator on the outside of your broken bone. It will be taken off when your bones have healed. The incision is closed with stitches. Steri-strips (thin strips of tape) may be put over your incision. A brace or cast will be put on your leg to keep the bones straight while they heal.

After your surgery:

You will be taken to a recovery room until you are fully awake. Caregivers will watch you closely for any problems. When caregivers see that you are okay, you will be taken to your hospital room. Do not get out of bed until your caregiver says it is okay. A caregiver will check your bandage and brace or cast after surgery.

  • Activity: Exercise your uninjured leg in bed when your caregiver says it is okay. Lift your leg off the bed and draw big circles with your toes. This helps prevent blood clots. Your caregiver will tell you when it is okay to get out of bed. Call your caregiver before you get up for the first time. If you ever feel weak or dizzy, sit or lie down right away then push your call button.

  • Brace or cast: A brace or cast will be put on your broken leg after surgery.

  • Deep breathing and coughing: This will help decrease your risk for a lung infection after surgery.

    • Hold a pillow tightly against your incision when you cough to help decrease pain. Take a deep breath and hold it for as long as you can. Deep breaths help open your airways. Let the air out and follow with a strong cough. Spit out any mucus you cough up. Repeat the steps 10 times every hour.

    • You may be given an incentive spirometer to help you take deep breaths. Put the plastic piece into your mouth and take a slow, deep breath. Let out your breath and cough. Repeat the steps 10 times every hour.

  • Drains: Thin rubber tubes may be put into your skin to drain fluid from around your incision. They will be taken out when the incision stops draining.

  • You will be able to drink liquids and eat certain foods once your stomach function returns after surgery. You may be given ice chips at first. Then you will get liquids such as water, broth, juice, and clear soft drinks. If your stomach does not become upset, you may then be given soft foods, such as ice cream and applesauce. Once you can eat soft foods easily, you may slowly begin to eat solid foods.

  • Medicines:

    • Antibiotics: This medicine helps fight infection caused by bacteria. Antibiotics may be given by IV, as a shot, or by mouth.

    • Antinausea medicine: This medicine may be given to calm your stomach and to help prevent vomiting.

    • Blood thinners: This medicine helps prevent clots from forming in the blood. Blood thinners may be given before, during, and after a surgery or procedure.

    • Pain medicine: Caregivers may give you medicine to decrease your pain. This medicine may be given as a shot, by mouth, or through your IV. Tell caregivers if the pain does not go away or comes back. A special pump may be used that allows you to push a button and give yourself the medicine through your IV. This is called patient-controlled analgesia and is set up so you cannot give yourself too much medicine.

    • Bowel movement softeners: This medicine helps soften your bowel movement to prevent constipation. It will also help prevent straining when you have a bowel movement.

  • Pressure stockings: These are long, tight stockings that put pressure on your legs to promote blood flow and prevent clots.

  • Pneumatic boots: Inflatable boots are put on your legs. The boots are connected to an air pump. The pump tightens and loosens different areas of the boots to help prevent blood clots.

© 2014 Truven Health Analytics Inc. Information is for End User's use only and may not be sold, redistributed or otherwise used for commercial purposes. All illustrations and images included in CareNotes® are the copyrighted property of A.D.A.M., Inc. or Truven Health Analytics.

The above information is an educational aid only. It is not intended as medical advice for individual conditions or treatments. Talk to your doctor, nurse or pharmacist before following any medical regimen to see if it is safe and effective for you.

Learn more about Open Reduction And Internal Fixation Of A Leg Fracture (Inpatient Care)

Hide
(web3)