ORIF cost in South Africa

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.
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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 are the factors affecting the cost of ORIF in South Africa?

The ORIF package cost in South Africa varies from one hospital to another and may offer different benefits. There are many hospital that cover the cost of pre-surgical investigations of the patient in the treatment package. The ORIF cost in South Africa 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 South Africa.

Which are some of the best hospitals in South Africa for ORIFt?

ORIF in South Africa is offered by multiple hospitals across the country. The top hospitals for ORIF in South Africa include the following:

  1. Ahmed Kathrada Private Hospital
  2. Netcare Linksfield Hospital
  3. Life Kingsbury Hospital
  4. Ethekwini Hospital and Heart Centre
How many days does it take to recover post ORIF in South Africa?

Upon discharge from the hospital after ORIF in South Africa, the patients are advised to stay for about 14 days for 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.

Which are some of the other popular destinations for ORIF?

South Africa is one of the most popular countries for ORIF in the world. The country offers the best cost of ORIF, best doctors, and advanced hospital infrastructure. Some of such countries are:

CountryCost
CzechiaUSD 8500
IndiaUSD 4700
ThailandUSD 9400
TurkeyUSD 6000
United Arab EmiratesUSD 8200
United KingdomUSD 10500
How much are the other expenses in South Africa apart from the cost of ORIF?

There are certain expenses additional to the ORIF cost that the patient may have to pay for. These are the chanrges for daily meals and hotel stay outside the hospital. The per day cost in this case may start from USD 50 per person.

Which are the best cities in South Africa for ORIF Procedure?

There are many cities that offer ORIF in South Africa, including the following:

  1. Lenasia
  2. Durban
  3. Cape Town
  4. Johannesburg
How many days does one have to spend in the hospital for ORIF in South Africa?

After the ORIF takes place, the average duration of stay at the hospital is about 2 days. This phase is important to ensure that the patient is recovering well and is clinically stable. During this time, several tests are performed before the patient is deemed suitable for discharge.

What is the average rating of Hospitals in South Africa offering ORIF?

The average rating for ORIF hospitals in South Africa is 2.9. Several parameters such as hospital infrastructure, pricing policy, quality of services, politeness of staff etc. contribute to the rating.

How many hospitals offer ORIF in South Africa?

There are more than 4 hospitals that offer ORIF in South Africa. The above listed hospitals are approved to perform the surgery and have proper infrastructure to handle ORIF patients. Such hospitals follow all legal protocols and guidelines as specified by the local medical affairs body when it comes to the treatment of international patients.

Who are the best doctors for ORIF in South Africa?

Some of the most sought after doctors for ORIF in South Africa are:

  1. Dr. Chris McCready

FAQ's Related to South Africa

Which are the popular multispecialty hospital groups in South Africa?

The popular multispecialty hospital groups in South Africa are:

  1. Ahmed Al-Kadi Private Hospital
  2. Busamed Hillcrest Private Hospital
  3. Busamed Gateway Private Hospital
  4. Busamed Modderfontein Private Hospital
  5. Busamed Lowveld Hospital
  6. Lenmed Ethekwini Hospital and Heart Centre
  7. Busamed Paardevlei Private Hospital
  8. Life Bay View Private Hospital
  9. Lenmed Shifa Hospital

These hospitals have taken the patient experience to the next level by ensuring the below things:

  1. Providing clear information about medicines to patients
  2. Effective engagement between nursing staff/doctors and patients;
  3. Suitability of the hospital environment for meeting the needs of patients
  4. Effectively managing pain.

The hospitals are bound to provide quality treatment as the government of South Africa has framed strict healthcare rules to ensure there is no quality lapse. Supported by state-of-art infrastructure, advanced medical equipment, and highly qualified doctors, the hospitals offer various facilities to improve the patient experience.

What healthcare accreditation standards are followed in South Africa?

In South Africa, the healthcare system is bound to follow standards set by the Joint Commission International (JCI) and Council for Health Service Accreditation of Southern Africa (COHSASA). To ensure that integrated and coordinated care is provided, COHSASA develops as well as measures standards in all areas and departments of a healthcare facility. SafeCare program has been introduced by COHSASA, JCI, and SafeCare Foundation to use internationally recognized standards to improve health care delivery. Clinics and Hospitals that comply with standards are initially given two-year accreditations and this period is extended if they are consistent in providing quality care.

Why should I opt for healthcare in South Africa?

South Africa is gaining global attention for medical tourism due to affordable treatment costs and world-class infrastructure. South Africa’s growing popularity in medical tourism is also attributed to factors like a large pool of accredited hospitals, advanced technology, world-class facilities provided by hospitals, global exposure of doctors. Liberal laws for the use of stem cells in South Africa have helped it attract a large number of medical tourists for advanced medical treatment. The hospitals in South Africa aim to destress your medical holiday by dealing with all of the organization and administrative tasks, as well as provide intensive care and assistance on a 24/7 basis.

How is the quality of doctors in South Africa?

With quality at their core, the well-trained and highly qualified doctors in South Africa provide world-class treatment. Many doctors in South Africa receive their training in foreign countries like Australia and Cuba which provide them global exposure and make them more competent in handling cases with high precision and accuracy. The doctors deliver great results in dental procedures and fertility treatments and provide complete patient satisfaction through a holistic approach. Some important factors which contribute to the production of good quality doctors in the country are education at premier colleges, adherence to global standards, patient-centric approach, and incorporation of the human touch in treatment.

How to obtain a medical visa in South Africa?

You can get a medical visa to South Africa for 90 days. The High Commission of the country decides for how long a visa could be extended. People need to apply for a temporary residency permit in case they have to stay in the country for more than three months. A visa becomes valid the day it is issued by the High Commission and not on the date of departure. Also, an application for a visa is not be accepted more than 30 days before departure. Make sure you have the below-listed documents while applying for a medical visa:

  1. Passport
  2. Passport-sized photographs
  3. Online Application form
  4. Full return flight reservation
  5. Proof of stay in South Africa
  6. Signed official medical letter from medical institution
  7. Signed medical letter from a recognized local practitioner
What are the popular procedures available in South Africa?

South Africa is known to offer some procedures with high success rates, such as total knee replacement, meniscus repairs, hip replacement, anterior cruciate ligament (ACL) reconstruction. Cosmetic surgery and infertility treatment are some of the other popular procedures in South Africa which have a high success rate. Fertility treatment through egg donation has seen a high success rate in South Africa wherein a person can opt for a surgical or non-surgical procedure, with quite low waiting times. The reasons for the popularity of these procedures are affordable treatment cost, speedy recovery, use of advanced technology, and highly trained doctors.

Which are the most popular cities in South Africa for medical treatment?

South Africa has a number of modern urban centers, such as Cape Town, Johannesburg, Pretoria, and Durban. Cape Town a major tourist attraction that has a rich culture, world-class doctors, and modern health facilities. An efficient public transportation system, affordable accommodation, connectivity through airlines, and a wide range of food options are some of the reasons for the popularity of these cities among medical tourists. Johannesburg’s public and private healthcare sectors work in coordination with South Africa's medical schools to produce internationally recognized medical specialists and the city’s medical care quality matches with that of Great Britain.

Is it mandatory to take vaccinations before going to South Africa?

Yes, some vaccines are highly recommended or required for South Africa. WHO and the National Travel Health Network and Centre recommend the following vaccinations: hepatitis A, yellow fever, rabies and tetanus, hepatitis B, typhoid, cholera. Infants of 6 to 11 months old are at greater risk of contracting measles, so they must get MMR vaccine before travelling to South Africa. People staying with friends or relatives or visiting smaller cities or rural areas should get typhoid vaccine. You can connect with your doctor or the hospital in South Africa for the required vaccines. Also, refer to the travel advisory issued by the government.

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