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Open Reduction and Internal Fixation of a Leg Fracture in Children

What is open reduction and internal fixation?

  • 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 any of the bones of your child's leg. These bones may include 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.
    Leg Bones
  • Leg fractures may be simple (a single crack or break), or may include bones that break into many pieces. They usually happen because of a direct blow or if the leg is hit straight on. During ORIF, small metal plates (strips of metal), rods, and screws will hold together broken pieces of bone inside the leg. While being held together, the pieces of broken bone will grow together and get stronger.

What are the signs and symptoms of a leg fracture?

Your child may feel a severe pain in his leg. A lump, swelling, and bruise may also be seen at the site of the fracture. Your child may have trouble walking or putting weight on the affected leg. He may also have difficulty raising the affected leg while lying down. A bone may even stick out through the skin. He may also have a deep cut reaching down to the bone and have lots of bleeding.

When does my child need an open reduction and internal fixation?

Your child may usually need open reduction and internal fixation for a leg fracture after trauma. Trauma includes bad injuries caused by a fall, car accident, sports injury, and physical abuse. His bone may break into several pieces, and may be hard to put back together without surgery. His leg fracture may be near important parts of his leg bones like the epiphyses (growth plates). This part of the leg bone is where new bone grows, making your child grow taller. Fractures may affect the epiphyses and your child's growth.

What tests are needed before an open reduction and internal fixation?

Your child's caregiver will get a complete medical history and do a physical examination. He may also ask about how your child broke his leg. Your child may need one or more of the following tests:

  • X-rays: Your child may need x-rays of his leg to check for broken bones or other problems. Several pictures may be taken of the bones in your child's leg. An x-ray of his uninjured leg may also be taken.
  • Computerized tomography scan: This test is also called a CT or CAT scan. This is a type of x-ray that uses computers to take pictures of your child's leg. Your child may be given a dye before the pictures are taken to help caregivers see the pictures better. People who are allergic to iodine or shellfish (lobster, crab, or shrimp) may be allergic to some dyes. Tell your child's caregiver if your child is allergic to shellfish or has other allergies or medical conditions.
  • Magnetic resonance imaging scan: This test is also called an MRI. The test uses magnetic waves to take pictures of the legs and knees.

Where can I find more information?

Having a leg fracture may be hard for your child and your family. Contact the following for more information:

  • American Academy of Family Physicians
    11400 Tomahawk Creek Parkway
    Leawood , KS 66211-2680
    Phone: 1- 913 - 906-6000
    Phone: 1- 800 - 274-2237
    Web Address:
  • American Academy of Orthopaedic Surgeons
    6300 North River Road
    Rosemont , IL 60018-4262
    Phone: 1- 847 - 823-7186
    Web Address:

Care Agreement

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

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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