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.
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.
ORIF surgery is not performed for minor accidental injuries, fractures or cracks. The procedure is implemented on patients who have:
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:
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.
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.
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:
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.
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.
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.
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.
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.
ORIF package cost in Israel has different inclusions and exclusions. The top hospitals for ORIF in Israel covers all the expenses related to the pre-surgery investigations of the candidate. The ORIF cost in Israel includes the cost of anesthesia, medicines, hospitalization and the surgeon's fee. A prolonged hospital stay due to delayed recovery, new diagnosis and complications after surgery may increase the cost of ORIF in Israel.
While the speed of recovery may vary from patient to patient, they are still required to stay for about 14 days after discharge. This is important to ensure that the surgery was successful. During this time, control and follow-up tests take place to check for medical fitness.
One of the topmost destinations for ORIF is Israel. It has a variety of accredited hospital, affordable cost of treatment and some of the best medical fraternity. Some of the other popular destinations for ORIF include the following:
|United Arab Emirates||USD 8200|
|United Kingdom||USD 10500|
Apart from the cost of ORIF, the patient is also required to pay additionally for daily meals and guest house accommodation. The per day extra expenses in Israel per person are about USD 50 per person.
The following are some of the best cities for ORIF in Israel:
After ORIF, the patient is supposed to stay for about 2 days in the hospital for recovery and monitoring. The doctors team review the patient's recovery during this time with the help of blood tests and imaging scans. Once they feel that everything is on track, the patient is discharged.
There are more than 6 hospitals that offer ORIF in Israel. These clinics have propoer infrastructure as well as offer good quality of services when it comes to ORIF These hospitals comply with all the rules and regulations as dictated by the regulatory bodies and medical association in Israel
The hospitals in Israel adhere to the healthcare standards framed by Joint Commission International (JCI). JCI is an independent organization that accredits and certifies healthcare organizations across the globe. With strict rules in place, the hospitals in Israel comply with the medical protocols and international standards to ensure the quality of treatment and patient safety. The standards help set a quality benchmark which helps the hospitals to monitor, assess, and improve the standards of quality healthcare.
Some of the world-class multispecialty hospitals with modern infrastructure in Israel are:
All kinds of surgeries are offered at these multispecialty hospitals and they follow strict medical protocols. These hospitals house highly experienced and well-trained doctors who can handle even the most complicated cases. The hospitals provide world-class treatments at an affordable cost.
Israel is one of the top destinations for medical tourism which boasts of having modern infrastructure, talented doctors, and world-class healthcare system. Israel has the best hospitals which provide world-class medicine with a personal touch to patients from across the globe. Each year thousands of patients visit Israel from different countries, including the United States, and Nigeria, Russia, Ukraine, Cyprus, Kazakhstan, Georgia, Bulgaria, Romania, Hungary. Israel’s popularity in medical tourism is credited to several factors, such as best medical infrastructure, highly qualified doctors, cheap accommodation, transportation facilities, and a wide range of food choices.
Most of the doctors in Israel are board-certified who ensure that they provide top-quality care to their patients. Israel has one of the world’s best doctors who guarantee excellent treatment results, which is attributed to their deep subject knowledge and holistic treatment approach. The highly professional doctors boast of having received education at premier educational institutions in the world. The quality of doctors and medical staff in Israel is very good and most of these doctors have exposure of working in different parts of the world.
You should carry documents like doctor referral notes, passport copies, medical History, test reports, records, residence/ driver’s license/ bank statement/ details of Health insurance. Once you have all the required set of documents, receiving medical treatment in Israel becomes very easy. Packing is an important task when it comes to traveling to another country for medical treatment because there are chances that you might miss any important document. The documents needed may differ as per your destination, so please check with the concerned authority before traveling.
Some of the popular procedures performed in Israel have received worldwide recognition, such as:
The popular procedures have a high rate of success and are performed by well-trained doctors with great precision and accuracy, ensuring complete patient safety and speedy recovery. Besides introducing a unique technology for safe hernia surgery with minor complications and fast recovery, Israel has achieved a milestone in bone implants done through tissue engineering technology. According to a study, the most common treatments in Israel are Botox injection and other fillings, along with hair implants.
Some of the most popular cities in Israel that attract a large number of medical tourists every year are:
These cities are bestowed with great cultural and natural beauty that is a plus for medical tourists who are looking for recreation after medical treatment. These cities have one of the best hospitals in Israel with a wide range of treatment options, affordable pricing, modern infrastructure, highly experienced doctors, and a wide range of facilities. Many other reasons that make these cities the most preferred destination for medical tourism are affordable accommodation, transportation facilities, a variety of food options, and scenic value.
To make patient’s hospital stay memorable, healthcare facilities in Israel offer all modern facilities, such as visa assistance, travel arrangements, airport transfers, coordination of all medical appointments, accommodations for patients and companions, international staff translators, shopping and recreational options, Internet with wi-fi, mobile sim cards, lockers, and a variety of food options. The hospitals provide all necessary facilities that are affordable and at par with international standards in order to provide a unique patient experience. The well-trained staff at hospitals guide patients by connecting with doctors, provide cost estimates, and schedule appointments that meet patients’ travel dates.
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