Open Reduction Internal Fixation (ORIF) Surgery in Czechia

Misplaced bones or bone fractures from an accident or physical injury can be cured either via closed reduction or open reduction methods. Where the former in non-invasive and allows the bones to heal without any surgery, the latter involves emergency surgical procedure for fixating the bones in their original position. ORIF surgery stands as an abbreviation for Open Reduction Internal Fixation surgery, which indicates an open surgical procedure for fixing internal broken bones. Mostly performed in case of emergencies, ORIF can also be implemented on candidates who are diagnosed with improper healing of past-fractures even after a prolonged period of time. In general, ORIF surgery cost varies from $1759 to $3675 and is performed in several major countries around the world. 

What is Open reduction internal fixation (ORIF)?

In severe case of bone dislocation, multiple fractures, exposure of bone cutting through the skin, open reduction internal fixation surgery is highly implemented. In this procedure, the surgeon may use rods, clips, plates, screws and other necessary objects in order to reposition the bone and allow it to heal. The objects inserted are henceforth removed after a certain period of time (as required), once the damaged portion has healed completely. Post-operation, the individual may have to avoid certain physical activity in order to prevent delaying of the healing process as well as other possible complication. 

Ideal Candidate for Open reduction internal fixation (ORIF)

ORIF surgery is not performed for minor accidental injuries, fractures or cracks. The procedure is implemented on patients who have:

  • Suffered severe bone fractures, which are otherwise irreparable with casts
  • Have had past fractures which have not yet healed and needs to be surgically corrected

Factors Affecting the cost of Open reduction internal fixation (ORIF)

The ORIF surgery cost depends on a number of factors. Apart from depending on the country where the procedure is being performed, the key determining factors are:

  • The area of damage
  • Extent of fracture or damage incurred
  • Type of object which needs to be inserted
  • Material of the implant required
  • Extent of surgery necessary.
Treatment and Cost

7

Total Days
In Country

2 No. Travelers

3 Day in Hospital

4 Days Outside Hospital

Treatment cost starts from

USD 8500

Hospitals

About the ORIF

Open reduction internal fixation (ORIF) procedure aims at fixing a bone fracture that is considered to be very serious and in case realignment of the bone to the normal position is required with the help of screws, plates and other equipment.

ORIF surgery is a common procedure and is applicable for different bone segments of the body, including the hip, knee, arms, and thighs. ORIF surgery is performed by orthopaedic surgeons who have specialization in the musculoskeletal structure of the human body.

 

Who needs ORIF?

ORIF surgery is performed to stabilize the broken bone, which could be in any part of the body. The following are some of the common conditions that are treated with the help of an ORIF surgery:

● The bone pieces such as knee, hip, tibia-fibula, humerus, and femur are significantly out of alignment

● The bone pieces are piercing out through the skin

● The part of the bones in the above-mentioned parts of body is fractured, leading to formation of several pieces

● The fracture involves a knee joint

● The healing of the bones is not normal even after undergoing conservative treatment

Open reduction means open surgery aimed to set the bones as may be necessary after a fracture, while internal fixation means fixing of plates or screws and intramedullary bone nails in the case of humerus, tibia or femur bones to facilitate in the overall process of healing.

Micro motion across the lines of fracture is prevented with rigid fixation which not only helps promote healing but also prevents further infection which can happen when plates such as dynamic compression plates are used as implants.

How is ORIF performed?

Once the patient is under the influence of anesthesia, an incision is made at the site of the injury or the break and then the fracture is carefully realigned or the joint is replaced with extreme precision. The hardware required will be installed and the incision made will be closed with the help of stitches and staples. The inserted implants such as rods, pins, screws, and plates are permanent in many cases. In some cases, the implants are temporary and can be removed when the healing begins.

A cast is usually applied after ORIF surgery. Later when the healing process has sufficiently progressed, this cast will be replaced with something that is capable of bearing better weight than that. The cast is completely removed after a few weeks of the ORIF surgery. The following are the different types of ORIF procedures, depending on the locations of the fracture:

1. ORIF Fractured Patella

Occasionally cerclage wiring is used alone or in combination with a tension band wiring. If the surgeon allows, then K-wires can also be used. The reduction is checked by palpating the retropatellar surface (which requires a small arthrotomy) while the cerclage is tightened with the knee in extension.

The proximal pin ends are bent after the cerclage is tightened. They are further shortened and turned towards the quadriceps tendon and then it is driven into the patella to prevent any skin irritation and further loosening.

To remove sharp points, the distal pin ends are trimmed but then it is not bent for the purpose of easy removal. Two twists can be preferred by some surgeons to tighten the cerclage wire. But then they have to take extra care to ensure that no extra prominent wires are left protruding.

As the wires get twisted, the surgeon pulls it away from the patella to have them tightened. To prevent fixation failure, the wires should be twisted at least 5 times. When stainless steel wires are tightened, they tend to lose the sheen of the surface and it can break with further tightening. Some care is taken to eventually have the twisted wire positioned deeper into the soft tissue muscle layers. This procedure is used to treat a fractured knee or a fractured patella.

 

2. ORIF Ankle

ORIF surgery for the ankle is performed in the prone position and a bump is placed under the ipsilateral hip. The patient may also be placed in the lateral decubitus position if medial malleolus fracture is not present.

Just medial to the posterior border of the fibula bone, a longitudinal incision is placed which allows good access to the Volkmann’s fragment and to the lateral malleolus. The sural nerve and saphenous vein are identified and protected.

The anatomy of the sural nerve is highly variable and hence meticulous blunt dissection has to be performed in the subcutaneous tissue. To gain access to the posterior aspect of the lateral malleolus, the peroneal tendons must be retracted medially. With the help of a lag and an antiglide plate, the fibular fracture is fixed classically but the construct of the fixation can vary depending upon the comminution and the fracture pattern.

Limited contact dynamic compression plate or one-third tubular plate can be employed to give additional stability in complicated fracture patterns. The latter plate is contoured by having the corners narrowed at the distal end to fit closely over distal fibula’s posterior border.

Within the wound, a second interval is further exploited between the Achilles tendon and the peroneal tendon more medially. From the posterior tibia, the flexor hallucis longus is lifted up to allow access to the posterior malleolus. Via the perimalleolar arterial, ring blood is supplied to the tibia. The fracture edge must be defined and devascularization of the fragment should not happen. In order to supplement the fixation, a small buttress plate can also be employed.

Through a standard medial incision, the medial malleolus can be addressed, but this can be challenging in a prone position when compared to the supine position due to the tendency of the leg to rotate externally. Hence it is good to have an assistant to hold the lower limb in case of internal rotation. Usually, with the help of two of the 3.5 lag screws, fixation of the medial side will be carried out.

 

3. ORIF Femur

Supracondylar fractures are common among femur fractures occurring proximal to the knee joint in the terminal of the femur in between the metaphyseal-diaphyseal junction and the femoral condyles. ORIF femur includes treatment of the fracture by incorporating intramedullary nails, plates and external fixators or total knee arthroplasty. The technique adopted will depend upon the bone quality and hemodynamic stability of the patient.

The angled blade plate of 95 degrees is a one-piece fixed angle device having a blade to be inserted in the condyles distally. But condylar screw system is much easier to use than angled blade plate. In the plate position, sagittal plane adjustments can be made which is not possible with blade plate. With an intercondylar split, the condylar screw is able to provide interfragmentary compression for the fractures.

With a cloverleaf distal portion that can be contoured, the condylar buttress plate is broad and can fit the lateral aspects of the distal femur. For the purpose of minimally displaced fractures, it can be used and most useful when fractures with articular extension in the sagittal and coronal planes have to be addressed. It is also used as an intraoperative backup device when some amounts of difficulties are faced while using the condylar screw system or the angled blade plate. In LISS or the less invasive stabilization system, a locking plate and a screw construct are used which ensures the preservation of the periosteal blood supply to the fracture. LISS plate is more useful in the case of osteoporotic bone.

 

4. ORIF Hip

The broken parts of the femur bone at the neck are put back in this surgery. The incision is made in the hip to view the damaged bone. The femur is straightened and broken pieces of the bone are put together.

Special metals, bars, plates, rods, screws can be used to keep the broken pieces together. An artificial implant may be placed to have the head of the femur specifically replaced. If the hip joint is also injured, an implant is placed to replace the hip socket too.

Recovery from ORIF

One of the main components of recovery is pain management after ORIF surgery. ORIF recovery time varies from one patient to the other, It also depends on the exact location of the surgery. ORIF ankle surgery recovery time is different from that of ORIF surgery of the hip. Recovery is typically painful and hence proper pain management is required after the ORIF surgery. Acetaminophen and codeine are usually prescribed. Research results reveal that ibuprofen or other kinds of nonsteroid anti-inflammatory drugs can slow down the process of healing during the recovery period. So these should be avoided during the recovery period.

Healing regimen physical therapy is also introduced during the recovery period since the body part that suffered the trauma will be held in an immobilized position for a very long period of time. As a result, the tendons, ligament, and muscles may grow weak with time.

With physical therapy, the strength comes back and endurance of the affected area increases with a range of motion. Physical therapy includes exercises, nerve stimulation, cold and hot packs, and ultrasound.

Patient Stories

Frequently Asked Questions

What is the health care infrastructure of Czechia / Why should opt for Czechia as a destination for your medical treatment?
Czechia is recognized for its strict rules and regulations which has kept the country in strict discipline. As an upside, the country has well-maintained regulations for every process and impressive medical healthcare facilities which has garnered thousands of visitors from across the world. The reasons for opting hospitals in Czechia is the astounding treatment options available at a very cost effective price range, which is undoubtedly affordable than most of the developed countries across the world. Besides the well-planned infrastructure, the treatment options and alternatives offered are tempting enough. Apart from that, the country also flaunts high success rates and has thus been able to cure some of the most complex diseases in the world.
What are the conditions of the hospitals in Czechia? Are they JCI certified. What is the quality of the support staff in the hospitals?
Contrary to a few decades back, the hospitals in Czechia have upgraded manifolds. The conditions of the multispecialty clinics have been modified to include the modern amenities and devices at large. This makes it ideally competent to the healthcare infrastructure in other developed countries making it capable of providing uncompromised treatment options to the medical tourists. A few of the hospitals and multispecialty clinics have earned due JCI certification and are thus, counted among the most trusted hospitals in the country. One of the most important aspects of availing healthcare benefits from any hospital is the quality of the support staff. Besides owning proficient doctors and surgeons, the efficiency of the support staff plays a major role on the health of the candidate. Keeping in mind the necessity, the staffs are well-trained to deal with every kind of situation thereby ensuring complete safety to the patients.
Are the doctors/surgeons in Czechia of the best quality?
One of the many reasons for the success of medical and health department of Czechia, is the supreme quality of the medical professionals. The doctors and surgeons providing treatments in Czechia are globally recognized for their service towards the medical field. Furnished with degrees from reputed universities and decades of training and experience, the doctors have earned high success rates throughout their professional career.
What is the process for obtaining medical visa in Czechia?
The Korean embassy follows a strict protocol for obtaining visa for travelling to the country. The necessary documents (photocopies and original) have been listed on their official website and should be strictly adhered to. However, one must definitely keep the documents at hand while applying for the same:
  • Two recent passport size photographs of the candidate not older than six months
  • Visa application fee which needs to be paid
  • Photocopy of the visa application fee paid
  • Confirmation of the duly filled visa application form
  • Civil status of the candidate
  • Copy of the entire travel itinerary
  • Proof of round ticket of flight as well as the accommodation reserved for staying
  • Other documents like birth certificate, residential proof, etc., which may also be required.
What support services does MediGence provide in Czechia?
Keeping in mind every travelling protocol listed by the government, MediGence ensures a hassle-free medical travelling experience in Czechia. Right from the beginning of the journey to the end, MediGence assists the candidates and the family with utmost care thereby making the stay as comfortable as it can be. Hence, here is a list of services provided for candidate satisfaction:
  • Medical travel and insurance query related support
  • Medical travel guidance
  • Visa Assistance
  • Free airport to hospital transfer
  • On-Ground Support
  • Teleconsultations
  • Visa Assistance
  • Accommodations Assistance
  • Free Airport to Hospital Transfer
  • Rehabilitation and recovery services
Which are the best cities in Czechia for medical treatment?
There are several cities which provide impressive medical benefits and are open for both national and international tourists. However, the best cities in Czechia for medical treatment are:
  • Seoul
  • Busan
  • Daegu
  • Incheon

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