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Closed Reduction Internal Fixation of Leg Fracture in Children


A closed reduction internal fixation (CRIF) of leg fracture

is a surgery. Your child's healthcare provider moves the broken bones in your child's leg, ankle, or foot into correct position. He or she may be able to do this without an incision being made over the break. Pins and wires are used to hold the pieces of bone in place. Flexible and non-flexible rods and nails, and metal plates may also be used.

How to prepare your child for a CRIF:

Your child's healthcare provider will tell you how to prepare your child for surgery. He or she may tell you to not let your child eat or drink anything after midnight the night before the surgery. Your child's healthcare provider will tell you what medicines your child should take or not take on the day of surgery.

What will happen during a CRIF:

  • Your child may be given general anesthesia to keep him or her asleep during the surgery. The anesthesia will also keep your child pain-free during the surgery. Your child may be given an antibiotic through the IV to decrease the risk for infection.
  • Your child's healthcare provider will use x-ray pictures to help him or her move the bones into the correct position. Once the bones are positioned correctly, pins and wires may be used to hold the bones in place. Instead, your child's healthcare provider may make an incision and place flexible nails or rods. He or she may need to place metal plates to hold the bones in place. The incision will be closed with stitches. Your child's healthcare provider will apply a splint or cast over your child's leg or foot. This will prevent movement and help the bones heal.

What will happen after a CRIF:

Your child will be monitored until he or she is fully awake. Your child may be taught how to use crutches. When the bone is healed, your child's healthcare provider may remove the pins, wires, and screws. Your child may need to participate in therapy. Physical and occupational therapies may help your child gain strength and keep complete range of motion in the affected leg. Your child may need to continue therapy after his or her break has healed.

Risks of a CRIF:

Your child may get an infection, or bleed more than expected. Your child's bone may not heal properly. The devices may cause irritation to your child's skin and tissues. Your child may need another surgery. Nerves, muscles, tendons, or blood vessels may be damaged during a CRIF. Your child may not have full range of motion of his or her leg.

Call 911 if:

  • Your child's leg feels warm, tender, and painful. It may look swollen and red.

Seek care immediately if:

  • Your child has extreme pain with movement of his or her leg.
  • Your child's toes are pale, blue, or gray.
  • Your child has pain that is not relieved by medicine.

Contact your child's healthcare provider if:

  • Your child has a fever or chills.
  • You have questions or concerns about your child's care or condition.

Care after surgery:

  • Apply ice to the area. Ice helps decrease swelling and pain. Ice may also help prevent tissue damage. Use an ice pack or put crushed ice in a plastic bag. Cover it with a towel and place it on your child's cast or splint in the fractured area. Leave it in place for 15 to 20 minutes every hour or as directed.
  • Elevate your child's leg as directed. Raise your child's leg above the level of his or her heart as often as you can. This will help decrease swelling and pain. Prop your child's leg on pillows or blankets to keep it elevated comfortably.
  • Do not allow your child to stick anything into his or her cast or splint. Hangers and other items can get stuck in your child's cast. These items can also cause injury to the skin.
  • Keep your child's splint or cast dry. Place a plastic bag over the splint or cast before your child bathes. Tape the bag to your child's skin to keep water out.
  • Limit your child's activity. Do not allow your child to put full weight on the injured leg. Have your child use crutches. Ask your child's healthcare provider when full weight can be put on the injured leg.
  • Give your child foods that contain calcium and vitamin D. Calcium and vitamin D help maintain healthy bones. Examples of high-calcium foods include kale, spinach, salmon, and fortified orange juice or breakfast cereal. Tuna, fortified milk or cheese, egg yolks, and soy milk are examples of vitamin D foods.
  • Take your child to therapy as directed. A physical therapist teaches your child exercises to help improve movement and strength, and to decrease pain. An occupational therapist teaches your child skills to help with daily activities. Have your child do the exercises as often as directed.

Follow up with your child's healthcare provider as directed:

Your child will need x-rays to see if the break is healing. Write down your questions so you remember to ask them during your child's visits.

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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.

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