What is ORIF Surgery?

ORIF, or open reduction internal fixation, is a surgical procedure that’s designed to repair a severe break or fracture in the bone. The “open reduction” part of the name is a reference to the surgery required to realign the bone into its normal position, while “internal fixation” is a reference to the plates, screws or rods necessary to keep the fracture stable for proper healing.

ORIF may also be used to refer to any surgical repair of any joint, including knee replacement.

ORIF surgery is performed by a surgeon specializing in orthopaedics and is done under general anesthesia. The procedure requires an incision at the site of the injury and very careful realignment of the fracture or joint that requires replacing. Hardware is set in place and the incision is then closed with either stitches or staples. Some hardware is permanent, although temporary hardware may be installed and later removed after healing is complete.

A cast is typically applied after ORIF surgery is done. In some cases, a non-weight bearing cast is used and replaced with a version that can bear weight after healing has progressed past a certain point. After a few weeks, the cast is removed.


There are a few possible complications to the procedure, including bacteria colonizing on the bone, infection, reduced range of motion, damage to surrounding muscles, nerve damage, chronic pain associated with the hardware, popping and snapping noises and possible surgery in the future to remove the pins, screws or plates.

Recovery from ORIF Surgery

Recovery after ORIF surgery is often painful, so your doctor will turn to pain management therapy to help control the pain. Acetaminophen with codeine is commonly prescribed, as NSAIDs like ibuprofen may inhibit healing. Always take medication as prescribed to manage pain post-surgery.

Orthopaedic physical surgery is also very important to speed healing and improve recovery. As the injured body part must usually remain immobile for weeks, the ligaments and muscles may become weakened from lack of use. Physical therapy remains the best way to restore the range of motion and strength and may be used along with pain management. Typical physical therapy after ORIF surgery includes exercises, nerve stimulation, ultrasound therapy and hot/cold packs.