Open Reduction with Internal Fixation of a Broken Bone

Open reduction with internal fixation is a type of surgery to fix a broken (fractured) bone. The doctor makes a cut, called an incision, in the skin over the bone. The doctor then moves the pieces of bone back into the normal position. This is called open reduction. The doctor may use special screws, pins, plates, or rods to hold the bone in place while it heals. This is called internal fixation. These devices may stay in your body from now on. The doctor closes the incision with stitches.

You will have a scar, but it will fade with time. You may spend from a few hours to a few days in the hospital. This depends on how serious your injury is. It usually takes 6 to 12 weeks for a broken bone to heal.

How soon you can go back to work and your normal routine depends on your job. It also depends on how long it takes your bone to heal. For example, if you have a broken leg and you sit at work, you may be able to go back in 1 to 2 weeks. But if your job requires you to walk or stand a lot, you may need to wait until your bone has healed.

Preparation

How do you prepare for an open reduction with internal fixation of a broken bone?

Surgery can be stressful. This information will help you understand what you can expect. And it will help you safely prepare for surgery.

Preparing for surgery

  • You may need to shower or bathe with a special soap the night before and the morning of your surgery. The soap contains chlorhexidine. It reduces the amount of bacteria on your skin that could cause an infection after surgery.
  • Do not shave the skin near the fractured bone for 2 or 3 days before surgery. This will reduce your risk of infection after surgery.
  • Be sure you have someone to take you home. Anesthesia and pain medicine will make it unsafe for you to drive or get home on your own.
  • Understand exactly what surgery is planned, along with the risks, benefits, and other options.
  • If you take a medicine that prevents blood clots, your doctor may tell you to stop taking it before your surgery. Or your doctor may tell you to keep taking it. (These medicines include aspirin and other blood thinners.) Make sure that you understand exactly what your doctor wants you to do.
  • Tell your doctor ALL the medicines, vitamins, supplements, and herbal remedies you take. Some may increase the risk of problems during your surgery. Your doctor will tell you if you should stop taking any of them before the surgery and how soon to do it.
  • Make sure your doctor and the hospital have a copy of your advance directive. If you don’t have one, you may want to prepare one. It lets others know your health care wishes. It’s a good thing to have before any type of surgery or procedure.

After the procedure

After open reduction with internal fixation of a broken bone: Overview

Your broken bone (fracture) was put into position and stabilized. You can expect some pain and swelling around the cut (incision) the doctor made. This should get better within a few days after your surgery. But it is normal to have some pain for 2 to 3 weeks after surgery and mild pain for up to 6 weeks after surgery.

How soon you can return to work and your normal routine depends on your job and how long it takes the bone to heal. For example, if you have a fractured leg and you sit at work, you may be able to go back in 1 to 2 weeks. But if your job requires you to walk or stand a lot, you will need to wait until your fracture has healed before you go back to work.

When to call

After open reduction with internal fixation of a limb: When to call

Call 911 anytime you think you may need emergency care. For example, call if:

  • You passed out (lost consciousness).
  • You have severe trouble breathing.
  • You have sudden chest pain and shortness of breath, or you cough up blood.

Call your doctor now or seek immediate medical care if:

  • You have pain that does not get better after you take pain medicine.
  • Your fingers or toes on the injured arm or leg are cool, pale, or change color.
  • You have tingling or numbness in your fingers or toes.
  • You cannot move your fingers or toes.
  • Your cast or splint feels too tight.
  • The skin under your cast or splint is burning or stinging.
  • You have signs of infection, such as:
    • Increased pain, swelling, warmth, or redness.
    • Red streaks leading from the incision.
    • Pus draining from the incision.
    • A fever.
  • You have drainage or a bad smell coming from the cast or splint.
  • You have signs of a blood clot, such as:
    • Pain in your calf, back of the knee, thigh, or groin.
    • Swelling in the leg or groin.
    • A color change on the leg or groin. The skin may be reddish or purplish, depending on your usual skin color.
  • You have new or worse nausea or vomiting.
  • You are too sick to your stomach to drink any fluids.
  • You cannot keep down fluids.

Watch closely for any changes in your health, and be sure to contact your doctor if:

  • You have any problems with your cast or splint.

Self-care

How can you care for yourself after an open reduction with internal fixation of a broken bone?

Activity

  • Rest when you feel tired. Getting enough sleep will help you recover.
  • Increase your activity as recommended by your doctor. Being active boosts blood flow and helps prevent pneumonia and constipation. It's usually okay to exercise other parts of your body as soon as you feel well enough.
  • Avoid putting weight on your repaired bone until your doctor says it is okay.
  • You will probably need to take 1 to 2 weeks off from work. It depends on the type of work you do and how you feel.
  • Do not shower for 1 or 2 days after surgery. When you shower, keep your dressing and incisions dry. If you have a cast, tape a sheet of plastic to cover it so that it does not get wet. It may help to sit on a shower stool.
  • Do not take a bath, swim, use a hot tub, or soak your affected limb until your incision is healed. This usually takes 1 to 2 weeks.

Diet

  • You can eat your normal diet. If your stomach is upset, try bland, low-fat foods like plain rice, broiled chicken, toast, and yogurt.

Medicines

  • Your doctor will tell you if and when you can restart your medicines. The doctor will also give you instructions about taking any new medicines.
  • If you stopped taking aspirin or some other blood thinner, your doctor will tell you when to start taking it again.
  • Take pain medicines exactly as directed.
    • If the doctor gave you a prescription medicine for pain, take it as prescribed.
    • If you are not taking a prescription pain medicine, ask your doctor if you can take an over-the-counter medicine.
  • If you think your pain medicine is making you sick to your stomach:
    • Take your medicine after meals (unless your doctor has told you not to).
    • Ask your doctor for a different pain medicine.
  • If your doctor prescribed antibiotics, take them as directed. Do not stop taking them just because you feel better. You need to take the full course of antibiotics.

Incision care

  • If you have strips of tape on the incision, leave the tape on for a week or until it falls off.
  • If you do not have a cast, clean the incision 2 times a day after your doctor allows you to remove the bandage. Use only soap and water to clean the incision unless your doctor gives you different instructions. Don't use hydrogen peroxide or alcohol, which can slow healing.

Exercise

  • Do exercises as instructed by your doctor or physical therapist. These exercises will help keep your muscles strong and your joints flexible while your bone is healing.
  • Wiggle your fingers or toes on the injured arm or leg often. This helps reduce swelling and stiffness.

Ice and elevation

  • Prop up the injured arm or leg on a pillow when you ice it or anytime you sit or lie down during the first 1 to 2 weeks after your surgery. Try to keep it above the level of your heart. This will help reduce swelling and pain.

Other instructions

  • If you have a cast or splint:
    • Keep it dry.
    • If you have a removable splint, ask your doctor if it is okay to take it off to bathe. Your doctor may want you to keep it on as much as possible. Be careful not to put the splint on too tight.
    • Do not stick objects such as pencils or coat hangers in your cast or splint to scratch your skin.
    • Do not put powder into your cast or splint to relieve itchy skin.
    • Never cut or alter your cast or splint.

Copyrighted material adapted with permission from Healthwise, Incorporated. This information does not replace the advice of a doctor.

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