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ORIF of a Wrist Fracture

AMBULATORY CARE:

What you need to know about open reduction and internal fixation (ORIF) of a wrist fracture:

ORIF of a wrist fracture is surgery to fix a broken wrist. Open reduction means that the bone is moved back into the right place with surgery. Internal fixation means that hardware (such as screws, rods, or pins) is used to hold the broken bones together.

Internal Fixation Device

How to prepare for ORIF:

  • Your surgeon will tell you how to prepare for surgery. He or she may tell you not to eat or drink anything after midnight on the day of surgery. Arrange to have someone drive you home after surgery.
  • Tell your surgeon about all medicines you currently take. He or she will tell you if you need to stop any medicine for surgery, and when to stop. He or she will tell you which medicines to take or not take on the day of surgery.
  • Tell your surgeon about all your allergies. Tell him or her if you had an allergic reaction to anesthesia or antibiotics.

What will happen during ORIF:

  • You may be given general anesthesia to keep you asleep and free from pain during surgery. You may instead be given local anesthesia to numb the area. You will be awake for surgery if you get local anesthesia, but you should not feel pain. Your surgeon will make one or more incisions on your wrist. The broken bones will be put back into the correct position. Medical plates, screws, pins, or wires will be used to hold the broken bones together. A bone graft may be placed in or around the fracture to strengthen your wrist.
  • X-rays may be taken during surgery to make sure the broken bone is set properly. X-rays also show if the pins, plates, and screws are placed correctly. Your surgeon will close your incision with stitches or staples. A splint will be placed over your wrist to prevent movement while your wrist heals.

What should I expect after ORIF:

You will be taken to a room to rest until you are fully awake. Healthcare providers will monitor you closely for any problems. Do not get out of bed until your healthcare provider says it is okay. When your healthcare provider sees that you are okay, you may be able to go home. Medicine may be given to relieve or prevent pain or nausea.

Risks of ORIF for a wrist fracture:

Your tendons and nerves may get injured during or after surgery. Your broken wrist may not heal properly. You may continue to have wrist pain. You may develop a life-threatening blood clot.

Call your local emergency number (911 in the US) for any of the following:

  • You suddenly feel lightheaded and short of breath.
  • You have chest pain when you take a deep breath or cough. You cough up blood.

Seek care immediately if:

  • Your arm or leg feels warm, tender, and painful. It may look swollen and red.
  • Your incision is red, swollen, or draining pus.
  • Your fingers look pale or blue, feel numb, or tingle.
  • Blood soaks through your bandage.

Call your doctor or surgeon if:

  • Your cast or splint breaks or gets damaged.
  • You have severe pain, even after you take pain medicine.
  • You have a fever.
  • You have questions or concerns about your condition or care.

Medicines:

  • Prescription pain medicine may be given. Ask your healthcare provider how to take this medicine safely. Some prescription pain medicines contain acetaminophen. Do not take other medicines that contain acetaminophen without talking to your healthcare provider. Too much acetaminophen may cause liver damage. Prescription pain medicine may cause constipation. Ask your healthcare provider how to prevent or treat constipation.
  • Take your medicine as directed. Contact your healthcare provider if you think your medicine is not helping or if you have side effects. Tell him or her if you are allergic to any medicine. Keep a list of the medicines, vitamins, and herbs you take. Include the amounts, and when and why you take them. Bring the list or the pill bottles to follow-up visits. Carry your medicine list with you in case of an emergency.

Self-care:

  • Apply ice as directed. Ice helps prevent tissue damage and decreases swelling and pain. Apply ice on your wrist for 15 to 20 minutes every hour or as directed. Use an ice pack, or put crushed ice in a plastic bag. Cover it with a towel before you apply it to your wrist.
  • Elevate your wrist. Keep your wrist above the level of your heart as often as you can. This will help decrease swelling and pain. Prop your wrist on pillows or blankets to keep it elevated comfortably.

  • Care for your splint or cast as directed. Ask when you can bathe. Follow your healthcare provider's directions for bathing with a splint or cast. Wrap a plastic bag around your wrist. Tape the bag closed so water will not get in while you bathe.
  • Ask when you can return to your normal daily activities. You may need to avoid lifting objects that are heavier than 5 pounds. Your healthcare provider may recommend that you exercise your fingers and arm. He or she will give you exercises to do.

Follow up with your doctor or surgeon as directed:

You will need to return to have your wound checked and stitches or staples removed. Write down your questions so you remember to ask them during your 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.

Further information

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