Having Tibia/Fibula Fracture Open Reduction and Internal Fixation (ORIF)

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

What to tell your healthcare provider

Tell your healthcare provider about all the medicines you take. This includes over-the-counter medicines such as ibuprofen. It also includes vitamins, herbs, and other supplements. Also tell your healthcare provider the last time you had something to eat or drink. And tell your provider if you:

• Have had any recent changes in your health, such as an infection or fever

• Are sensitive or allergic to any medicines, latex, tape, or anesthesia (local and general)

• Are pregnant or think you may be pregnant

Tests before your surgery

You may need an X-ray or other imaging scan to look at your bones.

Getting ready for your surgery

ORIF is sometimes done as emergency surgery after an accident or injury. Before this procedure, a healthcare provider will ask about your health history and give you a physical exam.

In some cases, tibia/fibula fracture ORIF is planned. You may need to have your leg placed in traction while you wait for surgery. Traction is a type of sling that holds your leg. Talk with your healthcare provider about how to get ready for your surgery. You may need to stop taking some medicines before the procedure, such as blood thinners and aspirin. If you smoke, you may need to stop before your surgery. Smoking can delay healing. Talk with your healthcare provider if you need help to stop smoking.

Also, make sure to:

• Ask a family member or friend to take you home from the hospital. You cannot drive yourself.

• Plan some changes at home to help you recover. You may need help at home.

• Follow any directions you’re given for not eating or drinking before the surgery.

• Follow all other instructions from your healthcare provider.

You may be asked to sign a consent form that gives your permission to do the procedure. Read the form carefully. Ask questions if something is not clear.

On the day of surgery

Your surgeon will explain the details of your surgery. These details will depend on the location and severity of your injury. An orthopedic surgeon with a team of specialized nurses will do the surgery. The preparation and surgery may take a couple of hours. In general, you can expect the following:

• You will likely have general anesthesia. This will prevent pain and make you sleep through the surgery. Or you may have regional anesthesia to numb the area and medicine to help you relax and sleep through the surgery.

• A healthcare provider watches your vital signs, like your heart rate and blood pressure, during the surgery.

• After cleaning the skin, the surgeon will make a cut (incision) through the skin and muscle of your leg.

• The surgeon will put the pieces of your tibia and fibula back into place (reduction).

• They will secure the pieces of the broken bones to each other (fixation). The surgeon may use screws, metal plates, wires, or pins. For certain tibia fractures, a special metal nail may be put through the middle of the bone.

• The surgeon will make other repairs to the area as needed.

• They will close the layers of muscle and skin around your thigh with sutures or staples.

After your surgery

Talk with your surgeon about what you can expect after your surgery. You may go home the same day. Or you may stay overnight in the hospital. Before leaving the hospital, you will likely have X-rays taken of your leg. This is to check the repair.

You will have some pain after the surgery. Your healthcare provider will tell you what pain medicine you can take to help reduce the pain. You can also use ice packs to help lessen pain and swelling. You might have some fluid draining from your incision. This is normal.

You’ll get instructions about how to move your leg and when you can put weight on it. For a while after your surgery, you may be told not to move your leg. You may need to wear a brace for several weeks. You may need to keep your leg dry.

Follow all of your healthcare provider’s instructions carefully. Your surgeon may tell you to:

• Take prescription medicine to prevent blood clots

• Not take certain over-the-counter medicines for pain that may interfere with bone healing

• Eat foods high in calcium and vitamin D to help with bone healing

Follow-up care

Make sure to keep all of your follow-up appointments. You may need to have your stitches or staples removed a week or so after your surgery.

You may have physical therapy to improve the strength and movement of your leg. The therapy may include treatments and exercises. Physical therapy improves your chances of a full recovery. Most people are able to return to their normal activities within a few months.

When to call your healthcare provider

Call your healthcare provider right away if you have any of these:

• Fever of 100.4°F (38°C) or higher, or as directed by your healthcare provider

• Chills

• Redness, swelling, bad smell, or fluid leaking from your incision that gets worse

• Pain in your leg or calf that gets worse

• Loss of feeling in your foot or leg