Open Reduction and Internal Fixation (ORIF)

After the surgery, you will be moved to the recovery room where you will be monitored closely until the anesthesia wears off. Side effects from general anesthesia may include headache, nausea, and vomiting, which can be managed with medication. Post-operative pain may be managed with regional anesthesia patient-controlled anesthesia (PCA), which allows you to press a button that administers a specific amount of pain-relieving medication intravenously. Both may have side effects that include nausea and vomiting as well as drowsiness. While you are on intravenous fluids, you will not be able to eat, but will be allowed to take sips of water. Once the intravenous is removed you will work your way up from a soft diet to normal food. The surgical site will be closed with stitches or staples, which will likely stay in place for 10 to 14 days. Drainage tubes may be inserted during this time to drain blood and fluids into a small vacuum bottle. The tubes are usually removed after 48 to 72 hours. It is important that the wound is kept dry and clean until it heals. An elastic bandage will be wrapped around the area and it is important to ensure that it isn’t too loose or too tight. Once wrapped you should be able to place one finger underneath the bandage and feel snug against that finger. If you cannot insert a finger, it is too tight. If it feels loose after one finger is inserted, it is too loose and should be rewrapped. While at the hospital, nurses will encourage you to cough and take deep breaths to prevent pneumonia. The affected limb will be elevated to prevent swelling. If able, you should get out of bed and take short walks a few times a day to prevent complications. Physical therapy may be prescribed to help you learn exercises to preserve muscle and range of motion. These may include: Exercising the quadriceps by contracting the muscles of your thighs so it can accommodate your weight when you can stand and walk again. Contract the muscles for five seconds and release. Continue until the muscle is fatigued. Exercising the joints to preserve range of motion. Exercising the hips by lying flat and raising one leg at a time and holding it for five seconds. Contract the muscles of the raised leg at the same time. Flexing and rotating your ankles to help with circulation. Gluteal setting exercise. Encouraging you to get out of bed (ambulation). If the surgery was done on your leg, you will not be able to get out of bed until you receive permission from your doctor. Initially you will need to use crutches to avoid placing any weight on the affected leg. Once you are able to walk well, the doctor and physical therapist may allow you to place partial weight on the affected leg. Pain can be controlled by elevating the limb when you are in bed. This will help increase blood circulation and prevent blood clots. If you had metal hardware placed in your leg and are not able to get up for a period, it is important to do exercises in bed to strengthen the muscles of the thighs, hips, and ankles of the affected leg as well as the unaffected one. This is to maintain muscle strength and tone as keep all the joints moving so they do not become stiff. Self care at home: Monitor the affected area for decreased sensation, increased swelling and severe pain that is not managed with medication. Also, watch for a high fever and coldness of the extremities. If you experience any of these symptoms, contact your doctor immediately. Follow the instructions of the physical therapist and do your exercises regularly to speed up recovery so you can resume normal activities. Do not overdo it and stop if you experience excessive pain or notice swelling. Once you are home, you may need to change your dressing once a day. Always observe the wound for signs of infection, such as swelling, redness, and seeping of fluid. Keep the wound clean and the dressing dry. Always come to all scheduled appointments, especially the one to remove the stitches as they can become infected if left in for too long. Keep your follow-up appointment, so your doctor can observe the wound and the healing of your bone, as well as for you to meet with a physical therapist. Maintain good health by eating nutritious food. There are usually no dietary restrictions.