Fracture fixation is surgery to stabilise broken bones, so they heal correctly. Metal implants, such as plates, screws, rods or wires, hold bone fragments in position. This approach, known as open reduction and internal fixation (ORIF), repairs the broken…

Overview of the procedure

Fracture fixation is surgery to stabilise broken bones, so they heal correctly. Metal implants, such as plates, screws, rods or wires, hold bone fragments in position. This approach, known as open reduction and internal fixation (ORIF), repairs the broken bone, prevents deformity and restores function.

Common reasons

Fixation is necessary when a cast cannot hold fragments, often due to road accidents, falls or sports injuries. Displaced, comminuted or open fractures usually need surgery for proper healing.

When is a procedure or surgery needed

Surgery may be recommended for unstable or significantly displaced fractures, fractures involving a joint surface, or fractures in which blood vessels or nerves are at risk. It is also indicated when non-surgical treatment fails to maintain bone alignment.

Procedure Details

Instructions before the procedure

• Do not eat or drink for 6–8 hours before surgery
• Inform your doctor about all medications, allergies and medical conditions
• Arrange for someone to take you home and assist you during early recovery

Step-by-step overview (non-technical)

• General anaesthesia is administered
• An incision is made over the fracture site
• Bone fragments are carefully repositioned (reduced) into normal alignment
• Metal implants (plates, screws, rods or wires) are fixed to hold the bone in place
• The wound is closed, and a brace or cast is applied if needed. It depends on which bone is broken

Type of anaesthesia

• Use general or regional anaesthesia to numb the area surrounding the broken bone

Duration

• Varies with fracture complexity; typically, 1–3 hours

Risks & Complications

• Infection, bleeding, blood clots, nerve or vessel injury, and wound healing problems
• Implant failure, malunion or non-union of the bone; further surgery may occasionally be required

Benefits & Outcomes

Expected results

• Restored bone alignment and stability
• Reduced pain and earlier return to movement
• Reduced risk of malunion, non-union and long-term deformity

How does it improve the quality of life

• Earlier mobilisation and independence compared with prolonged casting

During Hospital Stay

Instructions on the day of the procedure

• Wear loose, comfortable clothing and remove all jewellery
• Arrive early for pre-operative preparation and blood tests

Post-procedure monitoring

• Pulse, blood pressure and oxygen levels are closely monitored
• The surgical site is checked for bleeding, swelling and neurovascular status
• Pain relief, antibiotics and limb elevation are commenced after surgery
• Physiotherapy may begin the day after surgery to prevent stiffness

Recovery & Aftercare

Hospital stay

Length of stay depends on the fracture; most patients remain for 1–3 days, though complex fractures may require longer.

Recovery timeline

• Week 1–2: Pain management, wound care and rest with limb elevation
• Week 3–6: Gentle mobilisation and physiotherapy begin
• 6 weeks–3 months: Gradual return to weight-bearing as bone healing progresses
• 3–6 months: Return to normal activities guided by X-ray confirmation of healing

Activity restrictions

• Avoid bearing weight on the affected limb and driving until cleared by your surgeon
• No heavy lifting, strenuous activity or contact sport until advised

Wound care/precautions

• Keep the wound clean and dry; avoid soaking in water until fully healed
• Report any signs of infection, such as redness, warmth or discharge, to your doctor promptly

Lifestyle & Prevention

• Maintain a balanced diet rich in calcium and vitamin D, and avoid smoking, as it significantly impairs bone healing
• Use appropriate protective equipment during sports and follow safe practices to reduce injury risk

When to Contact a Doctor

Red flag symptoms

• Fever, increasing redness, swelling or wound discharge
• Sudden severe pain or loss of feeling in the affected limb
• Coldness, pallor or inability to move fingers or toes

Follow-up schedule

• 1–2 weeks: Wound check and review of post-operative X-rays
• 6 weeks: X-ray to assess bone healing and physiotherapy review
• 3 months: Functional assessment and return-to-activity planning
• Further visits as advised by your surgeon

Myths and Facts

FAQs