Ankle fractures generally occur because of twisting or direct blow injuries, such as a fall, or car accident.
The treatment regimen for an ankle fracture is decided by the location and severity of the fracture.
An ORIF, Open Reduction Internal Fixation surgery is considered when a simple cast or splint cannot repair the fracture.
Here the surgery is then performed to implant rods, plates and screws to hold the bones of the ankle in position until they heal and assume their structure and strength.
Open reduction specifically refers to incisions that the surgeon makes to realign the bones.
ORIF is generally an emergency procedure, when the ankle has broken in multiple locations, the alignment of the bones is disturbed, and if the bones are sticking out through the skin.
An ORIF may also be performed if a closed reduction surgery has been attempted earlier and the alignment and healing have not taken properly.
The surgery is meant to reduce pain and enable mobility.
An orthopedic surgeon performs the surgery.
The orthopedic surgeon summons numerous examinations besides physical examination:
The scans allow the surgeon to examine the broken bones in the ankle and plan for the surgery.
ORIF surgery is performed under general anesthesia. That means the patient is in deep sleep during the procedure and cannot sense anything.
It is a two-staged surgery and can take several hours depending on the extent of damage to the bones.
The first stage involves the surgeon cutting the skin and realigning the bones.
The second stage of the surgery is internal fixation. The surgeon fixes metal rods, screws, pins and plates to hold the repositioned bone together.
The hardware used is specific to that of ankle fracture.
The surgeon then sutures the incisions with staples or stitches and bandages the wound. An additional splint or cast may be put.
Post-surgery the patient is allowed to stabilize in the recovery room. The patient may be sent home the same day.
However, retaining the patient for a few days to monitor the wound and its recovery is preferred.
The recovery time ranges between three to twelve months of an ORIF surgery. This is governed by the extent of fracture that was repaired.
Following are the instructions a patient is likely to receive for an efficient recovery:
The doctor may prescribe some pain relief medication, which the patient needs to consume as per the schedule prescribed.
The patient will have to visit the doctor for the dressing of the surgical wound.
The doctor advises certain home care for the recovery of the surgical wound, which the patient needs to adhere to.
The leg on with the ORIF has been performed, during recovery needs to be positioned at an elevated position most of the times to avoid swelling.
Till the bones have healed, the patient should not bear any weight on that ankle.
The exercises which the physiotherapist gradually introduces need to be done regularly to ensure the functioning of the joint to reinstate.
Once the bones begin to heal, the surgeon refers to an occupational therapist or physiotherapist for the rehabilitation of the joint.
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