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Open Reduction And Internal Fixation Of A Leg Fracture In Children


  • Open reduction (re-DUK-shun) and internal (in-TER-nal) fixation (fik-SA-shun) (ORIF) of a leg fracture is surgery to repair your child's broken leg. A leg fracture is a break in the bones of his leg, such as the femur, tibia, fibula, and patella. The femur, or the thigh bone, is the longest bone in your child's body. The tibia, or shin bone, and the fibula, located behind the tibia, make up the lower leg. The patella, also called the kneecap, is the flat, triangular bone in the front of the knee joint. The leg bones help support your child's weight, and may break in different locations depending on the cause. Bad injuries caused by a fall, car accident, sports injury, and physical abuse may cause leg fractures. Your child may feel severe pain, have bruising and swelling, or have his bones sticking out through deep cuts on his skin.
    Leg Bones
  • ORIF is usually done if leg bones are broken at several places, or if bones are showing through deep cuts. It may also be done if blood vessels and nerves were also damaged. A failed attempt to repair the leg fracture without open surgery may also need an ORIF. During this surgery, your child's caregiver will make an incision (cut) over the broken bone. He may need to use drills, wires, screws, plates, and pins to align the broken bones and hold them together. While being held steady, the chips of broken bone will grow together and get stronger. Your child may need a cast or splint after his surgery. With an ORIF, your child's leg fracture may be treated and he may be able to resume his usual activities.



  • Keep a current list of your child's medicines: Include the amounts, and when, how, and why they are taken. Bring the list and the medicines in their containers to follow-up visits. Carry your child's medicine list with you in case of an emergency. Throw away old medicine lists. Give vitamins, herbs, or food supplements only as directed.
  • Give your child's medicine as directed: Call your child's primary healthcare provider if you think the medicine is not working as expected. Tell him if your child is allergic to any medicine. Ask before you change or stop giving your child his medicines.
  • Do not give aspirin to children under 18 years of age: Your child could develop Reye syndrome if he takes aspirin. Reye syndrome can cause life-threatening brain and liver damage. Check your child's medicine labels for aspirin, salicylates, or oil of wintergreen.
  • Antibiotics: This medicine is given to fight an infection caused by bacteria. Give your child this medicine exactly as ordered by his primary healthcare provider. Do not stop giving your child the antibiotics unless directed by his primary healthcare provider. Never save antibiotics or give your child leftover antibiotics that were given to him for another illness.
  • Pain medicine: Your child may need medicine to take away or decrease pain. Know how often your child should get the medicine and how much. Watch for signs of pain in your child. Tell caregivers if his pain continues or gets worse. To prevent falls, stay with your child to help him get out of bed.

Ask for more information about where and when to take your child for follow-up visits:

For continuing care, treatments, or home services for your child, ask for information.

Ask your caregiver when your child will need to return to have his stitches and cast removed.

Caring for your child's cast, splint, or brace:

  • Check the skin around the cast, splint, or brace every day. You may put lotion on any red or sore areas.
  • Do not let your child push down or lean on any part of the cast, splint, or brace. It may break.
  • Do not let your child scratch the skin under the cast, splint, or brace by putting a sharp or pointed object down it.
  • If your child has a plaster cast, do not let it get wet. When he takes a bath or shower, cover the cast with a plastic bag that is taped closed at the top.
  • Let him move his toes several times a day. This will decrease swelling and stiffness.

Physical therapy:

A physical therapist will help your child with special exercises. These exercises may be done 6 to 12 weeks after the surgery. Let your child do only the exercises advised by his caregiver and only as often as his caregiver suggests. Do not let your child do more than the range of motion exercises advised by his caregiver.

Preventing another fracture:

  • Never leave a baby alone on a changing table, bed or couch.
  • When driving, always put your child in a car safety seat in the back seat. Ask your caregiver for information about car safety seats.
  • Do not start the car until your child's seat belt is fastened.
  • Make sure your child wears protective gear (wrist guards, helmets, kneepads, and mouth guards) that meets safety standards when playing sports.
  • Never let your child roller-skate, ride a bicycle, go in-line skating, or skateboarding without a helmet. Ask your caregiver for information about bicycle helmet safety.


  • Your child has a fever.
  • Your child has chills, a cough, or feels weak and achy.
  • Your child is irritable and crying more than usual.
  • Your child's splint/cast feels tighter and you think his toes are getting more swollen.
  • Your child's skin is itchy, swollen, or has a rash.
  • There is a bad smell from your child's splint/cast.
  • You have any questions or concerns about your child's surgery, medicine, or care.


  • Your child's toes look pale or blue, and feel cold, numb or tingly.
  • Your child's splint/cast becomes soaked with blood.
  • Your child's cast breaks.
  • Your child's has trouble breathing all of a sudden.

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.

Further information

Always consult your healthcare provider to ensure the information displayed on this page applies to your personal circumstances.

Learn more about Open Reduction And Internal Fixation Of A Leg Fracture In Children (Aftercare Instructions)

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