Fracture Fixation (ORIF)
What is Fracture Fixation (ORIF)?
Open Reduction and Internal Fixation (ORIF) is a surgical procedure to repair a fractured bone by realigning (open reduction) the fragments and securing them with internal hardware (internal fixation), such as plates, screws, or rods. It’s used for fractures that cannot heal properly with casting or external fixation. In India, ORIF is performed in orthopedic departments at hospitals like Apollo, Fortis, Medanta, and AIIMS, often at affordable costs. Understanding the procedure, costs, recovery, risks, and FAQs is essential for patients.
Why do you need Fracture Fixation (ORIF)?
ORIF is indicated for:
- Displaced fractures:
- Bone fragments misaligned, requiring surgical realignment (e.g., distal radius, tibia, femur).
- Unstable fractures:
- Fractures likely to shift with casting (e.g., comminuted fractures, intra-articular fractures).
- Open fractures:
- Bone exposed, needing stabilization after wound cleaning (often after initial external fixation).
- Nonunion/malunion:
- Fractures that fail to heal or heal incorrectly after non-surgical treatment.
- Common sites:
- Wrist (distal radius), ankle, hip (femoral neck), forearm, or clavicle.
The procedure aims to restore bone alignment, promote healing, and regain function by using internal fixation devices, allowing earlier mobilization compared to casting.
Why Do ORIF Costs Vary in India?
Costs range from ₹60,000 to ₹2.5 lakh:
- Fracture Complexity: Simple fractures (e.g., wrist: ₹60,000–₹1 lakh); complex fractures (e.g., femur, pelvis: ₹1.5–2.5 lakh).
- Hospital/Location: Higher in metro cities (Apollo, Fortis: ₹1–2.5 lakh); lower in government hospitals (AIIMS: ₹20,000–₹50,000, often subsidized under Ayushman Bharat).
- Surgeon’s Expertise: Experienced orthopedic surgeons charge more.
- Additional Costs: Hardware (plates/screws: ₹10,000–₹50,000), anesthesia (₹5,000–₹15,000), hospital stay (₹5,000–₹15,000/day), physiotherapy (₹5,000–₹20,000 for 2–3 months).
- Insurance: Covered for medical necessity; confirm with your provider.
Fracture Fixation (ORIF) Procedure
- Before Surgery Evaluation:
- Diagnosis:
- X-ray/CT: Assesses fracture pattern, displacement, and joint involvement.
- Blood tests: Blood sugar, clotting profile, infection markers (for open fractures).
- Soft tissue assessment: Checks for swelling, open wounds, or compartment syndrome.
- Medications: Stop blood thinners (e.g., aspirin) 5–7 days prior if safe; antibiotics (e.g., cefazolin) given pre-op for open fractures.
- Consent: Risks, including infection, are explained.
- Diagnosis:
- Surgical Techniques:
- ORIF:
- Performed under general or regional anesthesia (e.g., spinal), lasting 1–3 hours depending on fracture complexity.
- An incision is made over the fracture site (length varies: 5–15 cm).
- Bone fragments are realigned (open reduction) using surgical tools.
- Internal fixation devices are applied:
- Plates and screws: Secure bone fragments (e.g., distal radius, clavicle).
- Intramedullary nail: For long bones (e.g., femur, tibia).
- Screws alone: For smaller bones (e.g., scaphoid).
- Incision closed with sutures; a splint or cast may be applied for added stability.
- Intraoperative Tools:
- Fluoroscopy: Real-time X-ray to confirm alignment and hardware placement.
- Plates/screws/nails: Stabilize the fracture (e.g., titanium or stainless steel).
- Bone graft (if needed): For nonunion or bone loss (additional cost: ₹10,000–₹30,000).
- ORIF:
- After Surgery:
- Hospital stay: 2–5 days (longer for lower limb fractures or complications).
- Care: Ice, elevation, and compression to reduce swelling; keep incision dry.
- Pain management: Moderate pain for 3–7 days; managed with analgesics (e.g., paracetamol, tramadol).
- Instructions: Non-weight-bearing or partial weight-bearing (e.g., crutches for lower limbs) for 6–12 weeks; start physiotherapy early.
Recovery After ORIF
- Hospital Stay: 2–5 days.
- Post-Surgery Care:
- Pain/Swelling: Peaks at 3–7 days; ice and elevation help; resolves in 2–4 weeks.
- Mobility: Varies by site:
- Upper limb (e.g., wrist): Partial use in 2–4 weeks, full use in 6–12 weeks.
- Lower limb (e.g., tibia): Non-weight-bearing for 6–12 weeks, partial weight-bearing with crutches thereafter.
- Physiotherapy: Starts within 1–2 weeks; focuses on range of motion, strength, and gait (for lower limbs); continues 2–6 months.
- Hardware: Typically left in place unless symptomatic (e.g., irritation); removal (if needed) after 1–2 years (additional cost: ₹20,000–₹50,000).
- Activity: Avoid high-impact activities (e.g., running) for 6–12 months.
- Follow-Up:
- Visits at 1 week, 2 weeks (suture removal), 6 weeks, 3 months, and 6 months.
- X-ray: At 6 weeks, 3 months to monitor bone healing (callus formation).
Most resume normal activities in 3–6 months; full recovery (including sports) takes 6–12 months. Success rate: 90–95% achieve bone healing; functional outcomes vary (e.g., 80–90% regain near-normal function).
Risks and Complications
- Surgical Risks:
- Infection (2–5%): Superficial or deep (higher in open fractures); treated with antibiotics, may need hardware removal.
- Bleeding (1–3%): Hematoma at surgical site; may need drainage.
- Nerve/vessel injury (1–2%): Numbness or vascular compromise; rare with careful technique.
- Post-Surgery:
- Delayed healing (5–10%): Nonunion or malunion; may need bone grafting or revision surgery.
- Hardware issues (2–5%): Loosening, breakage, or irritation; may need removal.
- Stiffness (5–15%): Limited joint motion (e.g., ankle, wrist); managed with physiotherapy.
- Deep vein thrombosis (DVT, 1–3%, lower limbs): Blood clot; prevented with early mobilization, managed with blood thinners.
- Long-Term:
- Arthritis (5–15% over 10 years): Post-traumatic arthritis (esp. intra-articular fractures); managed with medication or surgery.
- Chronic pain (2–5%): At fracture site; usually resolves in 6–12 months.
Report fever, severe pain, swelling, or numbness promptly.
Frequently Asked Questions (FAQs)
When is ORIF needed?
For displaced, unstable, or intra-articular fractures that won’t heal properly with casting or external fixation.
Can I avoid ORIF?
Yes, for simple fractures: Casting or external fixation; ORIF is for complex or displaced fractures.
Is ORIF painful?
Moderate pain for 3–7 days post-surgery, managed with medication; discomfort reduces in 2–4 weeks.
How soon can I resume activities?
Upper limb: 6–12 weeks; lower limb: 3–6 months; sports: 6–12 months.
Is ORIF covered by insurance in India?
Yes, for medical necessity; confirm with your provider.
Signs of complications?
Fever, severe pain, swelling, or numbness.
Will the hardware be removed?
Usually left in place; removed if symptomatic (e.g., irritation) after 1–2 years.
Lifestyle changes post-surgery?
Follow weight-bearing instructions, attend physiotherapy, avoid high-impact activities for 6–12 months, and maintain follow-ups.
Conclusion
ORIF is a reliable procedure for stabilizing complex fractures, promoting healing, and restoring function with a high success rate. India’s top hospitals (Apollo, Fortis, AIIMS) provide affordable care, typically covered by insurance. Understanding the procedure, costs, recovery, risks, and FAQs helps patients approach surgery confidently. Consult an orthopedic surgeon for personalized guidance.
Looking for Best Hospitals for Fracture Fixation (ORIF)
Note: we are not promoting any hospitals
we are not promoting any hospitals we sourced all the details from google and hospitals website, please verify and start with your surgery here we go the list includes government, budget and superspeciality hospitals accreditation bodies are the National Accreditation Board for Hospitals and Healthcare Providers (NABH) and the Joint Commission International (JCI)
- click on your city and schedule your surgery now done in good hands.
| City | Minimum Price (₹) | Maximum Price (₹) |
|---|---|---|
Agra |
50,000 |
2,00,000 |
Ahmedabad |
80,000 |
3,00,000 |
Ajmer |
50,000 |
2,00,000 |
Aligarh |
50,000 |
2,00,000 |
Allahabad |
50,000 |
2,00,000 |
Amritsar |
70,000 |
2,50,000 |
Aurangabad |
70,000 |
2,50,000 |
Bangalore |
80,000 |
3,00,000 |
Bareilly |
50,000 |
2,00,000 |
Belgaum |
70,000 |
2,50,000 |
Bhopal |
70,000 |
2,50,000 |
Bhubaneswar |
70,000 |
2,50,000 |
Bikaner |
50,000 |
2,00,000 |
Chandigarh |
80,000 |
3,00,000 |
Chennai |
80,000 |
3,00,000 |
Coimbatore |
80,000 |
3,00,000 |
Dehradun |
70,000 |
2,50,000 |
Delhi |
80,000 |
3,00,000 |
Dhanbad |
50,000 |
2,00,000 |
Durgapur |
50,000 |
2,00,000 |
Faridabad |
80,000 |
3,00,000 |
Ghaziabad |
80,000 |
3,00,000 |
Gorakhpur |
50,000 |
2,00,000 |
Guntur |
70,000 |
2,50,000 |
Gurgaon |
80,000 |
3,00,000 |
Guwahati |
70,000 |
2,50,000 |
Gwalior |
50,000 |
2,00,000 |
Hyderabad |
80,000 |
3,00,000 |
Indore |
80,000 |
3,00,000 |
Jabalpur |
50,000 |
2,00,000 |
Jaipur |
80,000 |
3,00,000 |
Jalandhar |
70,000 |
2,50,000 |
Jamshedpur |
70,000 |
2,50,000 |
Jodhpur |
50,000 |
2,00,000 |
Kanpur |
50,000 |
2,00,000 |
Kochi |
80,000 |
3,00,000 |
Kolkata |
80,000 |
3,00,000 |
Kollam |
70,000 |
2,50,000 |
Lucknow |
70,000 |
2,50,000 |
Ludhiana |
80,000 |
3,00,000 |
Madurai |
70,000 |
2,50,000 |
Mangalore |
70,000 |
2,50,000 |
Meerut |
50,000 |
2,00,000 |
Moradabad |
50,000 |
2,00,000 |
Mumbai |
80,000 |
3,00,000 |
Mysore |
80,000 |
3,00,000 |
Nagpur |
70,000 |
2,50,000 |
Nashik |
70,000 |
2,50,000 |
Navi Mumbai |
80,000 |
3,00,000 |
Noida |
80,000 |
3,00,000 |
Patna |
50,000 |
2,00,000 |
Pune |
80,000 |
3,00,000 |
Raipur |
70,000 |
2,50,000 |
Rajkot |
70,000 |
2,50,000 |
Ranchi |
50,000 |
2,00,000 |
Surat |
80,000 |
3,00,000 |
Thane |
80,000 |
3,00,000 |
Vadodara |
70,000 |
2,50,000 |
Varanasi |
50,000 |
2,00,000 |
Visakhapatnam |
70,000 |
2,50,000 |
Disclaimer
This information is sourced from open platforms and is for general awareness only. Costs may vary based on individual cases. Please consult a qualified doctor for medical advice and explore options within your budget before deciding on the procedure.