Understanding Elbow Fracture Open Reduction and Internal Fixation (ORIF)

Open reduction and internal fixation (ORIF) puts the pieces of a broken bone back together so they can heal. Open reduction means the bones are put back in place during surgery. Internal fixation means that special hardware is used to hold the bone pieces together. This helps the bones heal correctly. The procedure is done by an orthopedic surgeon. This is a doctor with special training in treating bone, joint, and muscle problems.

How does an elbow fracture happen?

The elbow joint is a hinge type of joint. It's made up of 3 bones. The upper arm bone (humerus) forms the joint with two bones of the forearm (radius and ulna). The ulna forms the bony point of the elbow. Different kinds of injury can damage any of the bones that form the elbow joint. A common cause of a break is falling on an outstretched hand. Weak and brittle bones (osteoporosis) can make an elbow fracture more likely.

The bone may fracture into 2 or more pieces. In some cases, the bone may break, but the pieces are still lined up correctly. Or, the pieces may not line up correctly. This is called a displaced fracture.

Why is an elbow fracture ORIF done?

This type of injury needs ORIF to repair. Without ORIF, your broken elbow may not heal as it should. You are more likely to need ORIF for an elbow fracture if:

  • The pieces of your broken bone are not lined up correctly

  • Your broken bone went through your skin

  • Your bone broke into several pieces

How is elbow fracture ORIF done?

The surgeon lines up the bone pieces correctly again. They then connect the bones back in place with hardware. This is called internal fixation. The hardware may include screws, plates, rods, wires, or nails.

What are the risks of elbow fracture ORIF?

All surgery has risks. The risks of elbow fracture ORIF include:

  • Infection

  • Bleeding

  • Nerve damage

  • Bone healing out of line or not healing

  • Problems from anesthesia

  • Need for more surgery

  • Joint stiffness

  • Joint instability

  • Broken screws or plates

  • Arthritis of the joint (months or years later)

Your risks vary based on your age and general health. For example, if you are a smoker or if your bones are weak (low bone density), you may have a higher risk of certain problems. People with diabetes may also have a higher risk of problems. Talk with your healthcare provider about which risks apply most to you.

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