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Open Reduction and Internal Fixation of an Arm Fracture in Children


  • Open reduction and internal fixation (ORIF) is surgery that is done to fix a fractured (broken) bone. The upper arm bone is called the humerus. The two bones of the forearm (below the elbow) are called the radius and ulna. Your child may have broken his arm in a car crash, while playing sports, or by falling on his arm while it is extended. If a child's arm is twisted or hit by another person, it may break.
    Anatomy of the Arm
  • ORIF surgery may be done when one or more arm bones are broken or dislocated (moved out of place). With an open reduction, caregivers move the bone back into place during surgery. Internal fixation means that hardware (metal objects) are used to hold your child's bone together. Your child may need ORIF if caregivers did a closed reduction, but the bone did not heal. An ORIF is also done if a bone is broken into many pieces or there is bone sticking out of the skin. Open reduction and internal fixation surgery may decrease your child's arm pain and help his broken arm heal correctly.



  • 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.
  • Antibiotics: This medicine is given to help prevent or treat an infection caused by bacteria.
  • 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.

  • Your child may need x-rays of his arm, and his arm may be moved and rotated by his caregiver. Your child's stitches or staples may be taken out. If your child has a cast, caregivers will remove it after your child's arm has healed. Hardware, such as pins or wires, may be taken out. Ask caregivers for more information about hardware removal.


After surgery, your child will not be able to use his arm for activities such as lifting. Your child may not be able to play sports until his bone has healed. Ask caregivers to tell you what activities are best for your child while his arm heals. A caregiver called a physical therapist may help your child with exercises. These exercises may help strengthen his arm during and after it heals. Ask caregivers when your child may return to school.

Ice and heat:

Ice and heat may help decrease swelling and pain in your child's arm. Ask your child's caregiver when and how to put ice or heat on your child's arm.

Bathing and cast or splint care:

If you have a young child, ask caregivers how to bathe him. Do not let his cast or splint get wet until caregivers say it is okay. Ask caregivers for more information about how to take care of your child's cast or splint.


  • Your child has blood or pus (fluid) leaking from his arm wound.
  • Your child's splint or cast smells bad.
  • Your child has a fever.
  • Your child has pain, even after taking pain medicine to decrease it.
  • You have questions or concerns about your child's arm surgery, medicine, or care.


  • Your child's arm hurts when he moves his fingers.
  • Your child's arm or fingers feel cold.
  • Your child tells you that his fingers are tingling.
  • Your child's fingers look blue or pale (lighter in color than usual).
  • Your child's cast breaks, or his stitches or staples come apart.
  • Your child has chest pain, a fast heart beat, trouble breathing, or has fainted.
  • Your child tells you that his bandage or cast feels tighter.
  • It looks like the swelling is increasing in your child's fingers.

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 an Arm Fracture in Children (Aftercare Instructions)

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