In general, when to do O.R.I.F. vs Closed reduction? (Surgery, fractures)

[Knicks]

Are there simple GENERAL rules for when to do O.R.I.F. as opposed to closed reduction?? (and when to do pinning vs intramedullary rod fixation).

Thanks.

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[Raygun77]

Are there simple GENERAL rules for when to do O.R.I.F. as opposed to closed reduction?? (and when to do pinning vs intramedullary rod fixation).

Thanks.

when you can't externally reduce it....or it doesn't stay reduced?

Orthopods are simple like that

 

[45408]

when you can't externally reduce it....or it doesn't stay reduced?

Orthopods are simple like that

Basically. Dislocated hip/elbow/shoulder? Pop it back in. No such luck? ORIF.

If things are fractured, then you probably have to go in and fix that too.

 

[OveractiveBrain]

Are there simple GENERAL rules for when to do O.R.I.F. as opposed to closed reduction?? (and when to do pinning vs intramedullary rod fixation).

Thanks.

This is a REALLY GENERAL rule, so use it with a grain of salt:

If a fracture is comminuted, angular, or already open do ORIF.

If a fracture is NOT comminuted, NOT anguar, and still closed, do closed reduction with casting.

I would imagine if there is any involvement of the vascular or nervous system, one would do surgery.

I like to think about it in terms of how nasty it is. A severe, multiple sites fracture, with bone pooping through skin, going through the metaphasis and the diaphysis needs to have surgery. Little johny fell off a swing and his humerus is big and puffy, needs a cast.

P.S. Knicks, you should include advice and advise in your signature. Seems to get missed a lot on SDN

 

[Knicks]

This is a REALLY GENERAL rule, so use it with a grain of salt:

If a fracture is comminuted, angular, or already open do ORIF.

If a fracture is NOT comminuted, NOT anguar, and still closed, do closed reduction with casting.

I would imagine if there is any involvement of the vascular or nervous system, one would do surgery.

I like to think about it in terms of how nasty it is. A severe, multiple sites fracture, with bone pooping through skin, going through the metaphasis and the diaphysis needs to have surgery. Little johny fell off a swing and his humerus is big and puffy, needs a cast.

This is EXACTLY the type of response I was looking for.

Fanx!