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 cost in Tunisia varies from one hospital to the other. The top hospitals for ORIF in Tunisia covers all the expenses related to the pre-surgery investigations of the candidate. Typically, the package cost of ORIF in Tunisia includes the expenses related to the surgeon's fee, anesthesia, hospital, meals, nursing and ICU stay. Post-surgical complications, new findings and delayed recovery may have an impact on the total ORIF cost in Tunisia.
After ORIF in Tunisia, the patient is supposed to stay in guest house for another 14 days. This time frame is important to ensure that the surgery was successful and the patient is fit to fly back.
While Tunisia is considered to be one of the best destinations for ORIF owing to the standard of Hospitals, and expertise of doctors; there are a select few destinations which provide comparable quality of healthcare for the procedure Some of the other destinations that are popular for ORIF include the following:
|United Arab Emirates||USD 8200|
|United Kingdom||USD 10500|
Apart from the ORIF cost, the patient may have to pay for additional daily expenses such as for guest house after discharge and meals. The extra charges may start from USD 50 per person.
ORIF in Tunisia is offered in almost all metropolitan cities, including the following:
The average duration of stay at the hospital after ORIF is about 2 days for proper care and monitoring. 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 4 hospitals that offer ORIF in Tunisia. The above mentioned clinics have the required infrastructure and a dedicated unit where patients can be treated. 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.
Some of the best medical specialists for ORIF in Tunisia are:
We have outlined the most popular multispecialty hospitals in Tunisia for your reference:
Healthcare in Tunisia is synonymous with superlative service delivery and human touch while treating patients. When it comes to diagnosing health conditions and treating them well to the patients’ satisfaction, the multispecialty hospitals in Tunisia are able to accomplish it with efficiency and finesse. The world class infrastructure in the healthcare institutions such as hospitals and clinics in Tunisia are a good reason for you to opt for treatment in Tunisia.
The advanced healthcare infrastructure in the hospitals and clinics in Tunisia makes for a pretty good reason for you to get your healthcare in the country. The most qualified and skilled surgical, medical, paramedical and administrative personnel are present in the healthcare ecosystem in Tunisia which translates to the country being a great choice for your treatment needs. You can choose to get healthcare from Tunisia because of the lower costs, lesser waiting times and an all embracing approach to healthcare right from consultation to treatment follow ups or rehabilitation. The healthcare system in Tunisia is conscious of keeping high levels of cleanliness and as a medical traveler to Tunisia you are bound to feel absolutely safe and secure.
When it comes to performing procedures effectively, the doctors in Tunisia are able to do so with great results as their long term practical training and vast experience enables them to function well under pressure for long hours. The right approach to education is followed by doctors in Tunisia who are well educated and enhance this education as they continue to practise medicine leading to content patients. As a patient, you feel confident in your doctor in Tunisia as they are known to be good managers; they have to liaison with fellow doctors, other healthcare professionals, hospital personnel and leading teams when performing procedures successfully. It must be put forth that the doctors in the Tunisian healthcare system are good in people skills and thus great at managing relationships with fellow doctors and healthcare professionals and in leading teams.
The important documents that are needed for your medical travel to Tunisia are mentioned here for your convenience:
The documents that are important for you to carry to Tunisia must be representative of your itinerary and your medical treatment. An essential document for your medical travel to Tunisia, the medical visa would now be easier to get with the introduction of a more seamless online visa application process. An essential document for your medical travel to Tunisia, the medical visa would now be easier to get with the introduction of a more seamless online visa application process.
The popular procedures available in Tunisia are as follows:
It is the Spine and Orthopaedic treatments that are making waves in the medical travel industry in Tunisia. The advanced Breast Cancer treatment is making sure that a lot of medical travellers are heading to Tunisia to get a new lease of health and life. Breast Cancer treatment in Tunisia is constantly pushing to new frontiers of success everyday and is a good reason for the innumerable medical travellers coming to Tunisia.
Please find below the vaccinations that are important for you to take before your travel to Tunisia:
The CDC: The Centers for Disease Control and Prevention, the US agency and WHO: World Health Organisation, a UN body have suggested two kinds of vaccinations for your medical travel to Tunisia, the recommended travel and routine vaccines. When you are traveling to Tunisia, there are some vaccines that help you be proactively protected from ailments and are considered mandatory or routine and there are others that are suggested for certain potential hazards like Hepatitis A, Hepatitis B, Typhoid and Rabies. Though many health organisations recommend getting vaccinated before your medical travel to Tunisia, it is a wise move even without the suggested guidelines.
Whenever you are in the process of deciding to go to Tunisia for medical travel, the many additional facilities extended by the hospitals make the decision easier. We have outlined for you the various additional facilities that are there in the hospitals in Tunisia:
As an international patient availing any treatment option in Tunisia, you can avail virtual consultations before you begin your treatment and virtual post procedure evaluations and follow ups as well. The hospitals in Tunisia boast of extra facilities such as dietitians, physiotherapists and prayer rooms for the ones who believe in the power of prayer.
There are many great medical tourism destinations in Tunisia which is because of a combination of wonderful tourist places and excellent medical infrastructure. There are several good medical tourism hotspots in Tunisia and they are listed below:
In the 2020-21 Medical Tourism Index listing 46 countries, Tunisia has a good ranking of 38. This is because of the focus on healthcare, having good relationships with the European union and Arab nations and a strong tourism industry. The warm hospitality, easy visa norms, good healthcare at affordable prices together make Tunisia a major medical tourism destination.
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