ORIF or open reduction internal fixation surgery is a procedure performed to fix a broken bone with the help of surgical plates, nails, screws or pins. The hardware’s used during the methods can be permanent or temporary and removed once the healing is done.
Thailand is a famous tourist destination globally because of its exceptional hospitality and beautiful beaches. Along with that, the medical tourism industry is also gaining fame in, making it one of the most preferred destination. The main reason why Thailand is dominating the medical tourism sector is the quality of treatment provided, its economical pricing and the high-end facilities available. Most of the orthopedecian performing ORIF are famed for their commitment and skills. Majority of the hospitals in Thailand are offering international facilities with high -end diagnostic methods and advanced technology.
The cost of ORIF surgery in Thailand, with the quality of treatment, can be compared with some of the most preferred medical tourism destinations like Singapore, Turkey, India, Hungary, and UAE. ORIF Surgery costs in Thailand including the surgery, aftercare, and stay almost less than one-sixth 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.
ORIF cost in Thailand starts from about $9400. ORIF in Thailand is conducted across several Healthcare Accreditation Institute, JCI certified hospitals.
The ORIF package cost in Thailand varies from one hospital to another and may offer different benefits. The ORIF package cost usually includes all the expenses related to pre and post surgery expenses of the patient. The treatment cost usually includes the expenses related to hospitalization, surgery, nursing, medicines, and anesthesia. Stay outside the package duration, post-operative complications and diagnosis of a new condition may further increase the ORIF cost in Thailand.
After ORIF in Thailand, the patient is supposed to stay in guest house for another 14 days. 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.
Thailand 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|
Apart from the cost of ORIF, the patient is also required to pay additionally for daily meals and guest house accommodation. The extra charges may start from USD 50 per person.
There are many cities that offer ORIF in Thailand, including the following:
Patients who are interested in availing telemedicine consultation before they travel for ORIF in Thailand can opt for the same. There are many ORIF surgeons who offer video telemedicine consultation, including the following:
|Doctor||Cost||Schedule Your Appointment|
|Dr. Pibul Itiravivong||USD 121||Schedule Now|
The average duration of stay at the hospital after ORIF is about 2 days for proper care 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.
There are more than 6 hospitals that offer ORIF in Thailand. The above mentioned hospitals have the required infrastructure and a dedicated unit where patients can be treated. Additionally, these hospitals are known to comply with the international standards as well as local legal requirements for the treatment of patients.
The healthcare system in Thailand has no dearth of resources, be it financial, technological and human resources. The private healthcare and public healthcare work in tandem to create the strong healthcare infrastructure in Thailand. It is the Institute of Hospital Quality Improvement and Accreditation (HQIA) which maintains the standard and quality of healthcare in Thailand. The quest to get Thai HA accreditation by healthcare organisations leads to a susbstantial improvement in the service delivery levels.
The Thai hospitals approach to healthcare is rooted in the personal touch and the clinical care they provide to their patients. When you come to Thailand and find that there are so many different multispecialty hospitals, this gives you the chance to make the best choice from tho ones available. The globally recognised specialists provide the best treatment to patients and this makes them reliable. We bring to you some names of the multispecialty hospital groups such as:
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Make a checklist of all the documents that you need as you begin preparing for your Thailand visit. The documents are of different kinds such as travel related, treatment related and finances. The required documents are outlined here:
Thailand is an attractive medical tourism destination. It not only has tourist attractions but provides medical treatment at affordable costs. Some of the popular procedures available in Thailand are as follows:
Any international travel mandates immunisations and vaccinations. Ofcourse, you need to get immunised or vaccinated when coming to Thailand as well. We are outlining the vaccinations recommended by CDC and WHO. Yellow Fever, Japanese Encephalitis, Measles, Mumps and Rubella (MMR), TDAP (Tetanus, Diphtheria and Pertussis), Chickenpox, Shingles, Pneumonia, Influenza, Rabies, Meningitis, Polio, Hepatitis A, Hepatitis B, Typhoid and Cholera.
Healthcare infrastructure in Thailand is well equipped with the latest technological advancements. Whether you are a patient or a co traveller you can approach the center for International patients to get access to travel, transfer and accomodation needs. Integrated medical support services and emergency services add value to the existing facilities that hospitals provide in Thailand. There are several medical facilities that add value to your treatment experience in Thailand hospitals such as radiology services, operating theaters, Intensive care units, cardiac care units, diagnostic laboratory and pharmacies.
The combination of its excellent existing healthcare infrastructure and the various tourist attractions make Thailand a viable medical tourism destination. Thailand is a bargain as a medical tourist destination and this reflects in the fact that the cost of your travel plus treatment in Thailand is still lower than what you will spend to get treatment done in many other countries. There are several wonderful medical tourism destinations in Thailand which are a reflection of Thailand;s natural beauty, culture and excellence of healthcare facilities. The cities of Bangkok and Phuket are the best medical tourism destinations in Thailand.
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