Open reduction fracture also is known as ORIF is a surgical procedure performed to restore a severed bone fracture. It is recommended when the bone is significantly displaced, or the articular joint surfaces are disrupted, when the bone is not able to heal correctly on its own, in cases where closed reduction has failed.
Singapore has always been famed among the tourist and students, and of its counted amongst the top healthcare destination. Singapore has gained popularity in the medical tourism industry, and it reports a lot of medical tourists each year. With its world-class facilities, medical infrastructure, cleanliness, the safe and welcoming atmosphere it has seen an inflow in its orthopedic departments. They have a very efficient transport system, accommodation options which make things comfortable for the patients. ORIF Surgery in Singapore performed by some of the famed and skilled orthopedecian, who have received training from some of the best centers around the world.
ORIF surgery cost in Singapore along with quality medical care and safety are available at competitive prices with some of the most chosen medical tourism destinations like UAE, Thailand, India, Hungary, and Turkey. The surgery including the travel and accommodation cost in Singapore comes to less than half of the price when compared with the treatment cost offered in US or UK.
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.
Different hospitals have different pricing policy when it comes to the cost of ORIF in Singapore. Some of the best hospitals for ORIF offer a comprehensive package that covers the end-to-end expenses related to investigations and treatment of the patient. The ORIF cost in Singapore includes the cost of anesthesia, medicines, hospitalization and the surgeon's fee. Stay outside the package duration, post-operative complications and diagnosis of a new condition may further increase the ORIF cost in Singapore.
After discharge from the hospital, the patient has to stay for another 14 days in the country for complete recovery. During this time, the patient undergoes medical tests and consultations. this is to ensure that the treatment was successful and the patient us safe to return.
Singapore is considered to be one of the best places for ORIF in the world. This is because of the availability of some of the best doctors, advanced medical technology and good hospital infrastructure. Some of the other destinations that are popular for ORIF include the following:
|United Arab Emirates||USD 8200|
|United Kingdom||USD 10500|
There are certain additional cost that the patient has to pay apart from the ORIF cost. These charges starts from USD 50 per person.
ORIF in Singapore is offered in almost all metropolitan cities, including the following:
After ORIF, the patient is supposed to stay for about 2 days in the hospital for recovery and monitoring. The patient is subjected to several biochemistry and radiological scans to see that everything is okay and the recovery is on track. After making sure that patient is clinically stable, discharge is planned.
The average rating for ORIF hospitals in Singapore is 2.7. Several parameters such as hospital infrastructure, pricing policy, quality of services, politeness of staff etc. contribute to the rating.
There are more than 5 hospitals that offer ORIF in Singapore. These clinics have proper infrastructure for the treatment of patients who require kidney transplant. These hospitals comply with all the rules and regulations as dictated by the regulatory bodies and medical association in Singapore
The accredition of hospitals in Singapore is done by Joint Commission International as an international accredition agency. Joint Commission International or JCI makes sure that the hospitals in Singapore are keeping up standards of patient safety and healthcare quality. Hospitals in Singapore are apprised on Organisation management and accredited by the Joint Commission International gives it great value and good standing. The Joint Commission International keeps really stringent assessment measures before giving any hospital in Singapore the accredition.
The popular multi specialty hospital groups in Singapore are as follows
The patient ecosystem that frequents the popular multispecialty hospitals in Singapore is made up of international patients because of the high quality of medical care available. The quality of medical professionals and the wide variety of specialties covered by the Singapore multispecialty hospitals is the reason for the success of the popular multispecialty hospitals in Singapore. The best of medical treatment can be had in the popular multispecialty hospitals in Singapore at less waiting times.
You must choose your healthcare in Singapore because of the excellent healthcare infrastructure that defines the Singaporean healthcare landscape. The hospitals and healthcare professionals in Singapore are well defined with the best of clinical outcomes and an all round care. The fact that Singapore healthcare system is synonymous with high degree of commitment to provide service to their patients is the reason one must opt for healthcare in Singapore. Singapore is a medical tourism hub because it has high degree of access to quality healthcare for all and seamless travel opportunities.
The doctors in Singapore are thorough professionals with immense practical knowledge of their area of specialisation. It can be safely concluded that Singapore has good quality of doctors on the basis of their focus on precision and efficiency of treatment. As Singapore is a major international medical tourism destination, the doctors in Singapore have great international exposure which ensures that the quality of doctors in Singapore is very high. The high degree of skill and being educated from the best of the educational institutions in the world ensures that the doctors in Singapore are of very high quality.
We bring to you the list of documents needed for your medical travel to Singapore:
Kindly create a checklist of documents as you prepare your journey to Singapore for your medical travel. Your financial documents, travel documents and your medical condition related documents are the three kinds of documents that you need to carry on your medical travel to Singapore. The travel documents that you are carrying with you should cover your requirements as a medical tourist which will make your treatment, stay and travel back as streamlined as possible.
There are many important popular procedures that are performed in Singapore such as:
Cardiology procedures have long been the forte of healthcare providers in Singapore owing to their expertise stemming from the best of education and training in performing these procedures. The departments of Orthopaedic surgery in the hospitals in Singapore are performing major surgeries with precision and efficiency leading to excellent results. Singapore is a hub for cosmetic surgery procedures such as:
It is the hospitals in Singapore that are giving a world class treatment to their patients and their loved ones accompanying them by providing several additional facilities. Your medical travel and transfer process is sought to be made easy and effortless by the hospitals in Singapore by providing you facilities such as:
There are facilities available for medical travellers that ease the payment process such as private payment gateways and the option of availing private insurance. Patient centric care is ensured by the hospitals in Singapore in the form of health screening programmes, dietitians and pharmacies.
Singapore has relaxed visa norms for many countries and you must check the visa requirements for your country before applying for a medical visa for Singapore We have listed here the required documents for medical visa for Singapore:
It is advised that you check the required visa fee from your country for medical visa for Singapore. It takes atleast five working days to get your medical visa processed (excluding delays due to rush or submission of an incomplete application). Your financials must be in order for you to get a Singapore medical visa and you must submit your original bank statement to ensure this.
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