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 Switzerland has different inclusions and exclusions. 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 treatment cost usually includes the expenses related to hospitalization, surgery, nursing, medicines, and anesthesia. There are many things that may increase the cost of ORIF in Switzerland, including prolonged hospital stay and complications after the procedure.
While the speed of recovery may vary from patient to patient, they are still required to stay for about 14 days after discharge. This time frame is important to ensure that the surgery was successful and the patient is fit to fly back.
Switzerland 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. However, there are other countries as mentioned below that are popular for ORIF as well:
|United Arab Emirates||USD 8200|
|United Kingdom||USD 10500|
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. These charges starts from USD 50 per person.
Some of the cpopular cities in Switzerland that offer ORIF include the following:
After the ORIF takes place, the average duration of stay at the hospital is about 2 days. During the recovery, the patient is carefully monitored and control tests are performed to see that everything is okay. If required, physiotherapy sessions are also planned during recovery in hospital.
There are more than 2 hospitals that offer ORIF in Switzerland. These hospitals have propoer infrastructure as well as offer good quality of services when it comes to ORIF Additionally, these hospitals are known to comply with the international standards as well as local legal requirements for the treatment of patients.
The most popular hospitals in Switzerland are:
The country has more than 500 hospitals and boasts of some of the biggest private hospitals in the world. Around 12 hospitals are accredited and they adhere to international standards. A rising number of hospitals have developed centers of competence for outpatient diagnostic and therapy. Swiss hospitals deliver up to 70 percent of all out-patient services in a given region. Equipped with modern equipment and the latest medical technologies, the multispecialty hospitals in Switzerland are backed by the modern infrastructure to provide world-class treatment.
Healthcare systems in Switzerland are bound to sign contracts on the quality of medical care as per international standards. The healthcare facilities in Switzerland follow the standards set by International Standards Organization. Standard EN 45001 acts as a benchmark for the accreditation of healthcare providers. The quality of test results is decided after the assessment of the accepted values and requirements. The standards help set a quality benchmark which helps the hospitals to monitor, assess, and improve the standards of quality healthcare.
Medical tourism in Switzerland is regarded as amongst the highest standard in the world due to its highly qualified experienced staff and reputation, traditional values of quality, precision, cleanliness, and research-focus. Superior infrastructure and world-class healthcare facilities and research institutes make the country a global leader in the medical tourism industry. Switzerland has a number of premier research institutes that focus on finding new treatment methods. The Swiss are best known for their excellence in medical innovation. The other reasons why Switzerland has become a hot spot for medical tourism are world-class treatment, high level of privacy, and a wide range of treatment specialties.
Hospitals in Switzerland generally accept health insurance but always connect with your insurance company to check whether the treatment you want to undergo is covered at the hospital in the country. The hospital will request the Guarantee of Payment from the insurance to start your treatment cashless if it is an approved insurance provider. Usually, cosmetic surgery, pregnancy and abortion, and diagnostic tests are not covered under health insurance. If your insurance plan is not approved in Switzerland, you will have to pay for the treatment and later claim for reimbursement once you return to your country.
Switzerland has received worldwide recognition for reporting high success rates in the following procedures.
World-class clinics and hospitals, superior technology, and well-trained doctors are some of the reasons for the popularity of these procedures. Cosmetic surgery has become a very popular procedure in Switzerland and thousands of people from various parts of the world visit the country every year to avail it. The increasing popularity of IVF in Switzerland is mainly attributed to highly trained fertility experts, a large number of clinics, and personalized care.
Switzerland has a number of modern urban centers, such as Zurich, Lucerne, Bern, Basel, Geneva, Lausanne, Lugano. These cities have modern infrastructure, world-class hospitals, and highly trained doctors which contribute to providing quality treatment. A large number of medical tourists visit Zurich and Geneva every year because of several reasons like the availability of reasonably-priced hotel rooms, better transportation systems, and connectivity through airlines. These cities have become leading medical tourism destinations in Switzerland due to many other factors, such as a large pool of world-class hospitals, rich heritage, scenic value, availability of translators, and safety of tourists.
Yes, vaccination is mandatory before you travel to Switzerland. Some of the vaccines recommended by WHO and CDC are:
Some parts of Switzerland have recently had routine disease outbreaks. Make sure your MMR and other routine vaccinations are up-to-date. Vaccines and their dosage vary as per the traveler's age, immunization history, and current medical conditions. Before a trip to Switzerland, you can get pre-exposure vaccination against rabies and yellow fever.
Schengen Visa allows a person to travel to Switzerland to seek medical treatment. You are allowed to stay for a maximum of 90 days in Switzerland if you hold this visa. If your treatment is foreseen to last longer, you should apply for a National Visa for Medical Treatment. You need to produce the below documents to apply for a medical visa:
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