What is Humerus Fracture Treated With ORIF

A humerus fracture is a break in the in the upper arm bone (humerus). If the fracture is displaced, that means that one or more parts of the bone have been moved out of their normal position and are not lined up correctly.

Open reduction with internal fixation (ORIF) is a surgical procedure that may be used to treat a humerus fracture that is displaced. In this procedure, a surgeon will move parts of the bone back into the right position. The surgeon will put in a combination of plates, screws, or other types of hardware to hold the bones in place. The hardware that is put in during the procedure will likely be left in place after you heal. You will likely not know that it is there.

Tell a health care provider about:

• Any allergies you have.
• All medicines you are taking, including vitamins, herbs, eye drops, creams, and over-the-counter medicines.
• Any problems you or family members have had with anesthetic medicines.
• Any blood disorders you have.
• Any surgeries you have had.
• Any medical conditions you have.
• Whether you are pregnant or may be pregnant.

What are the risks?

Generally, this is a safe procedure. However, problems may occur, including:

• Excessive bleeding.
• Infection.
• Allergic reactions to medicines.
• Damage to nerves or blood vessels.
• Shoulder stiffness.
• Failure of the bone to heal (nonunion).

What happens before the procedure?

Staying hydrated

Follow instructions from your health care provider about hydration, which may include:

• Up to 2 hours before the procedure – you may continue to drink clear liquids, such as water, clear fruit juice, black coffee, and plain tea.

Eating and drinking restrictions

Follow instructions from your health care provider about eating and drinking, which may include:

• 8 hours before the procedure – stop eating heavy meals or foods such as meat, fried foods, or fatty foods.
• 6 hours before the procedure – stop eating light meals or foods, such as toast or cereal.
• 6 hours before the procedure – stop drinking milk or drinks that contain milk.
• 2 hours before the procedure – stop drinking clear liquids.

General instructions

• Ask your health care provider about:
  • Changing or stopping your regular medicines. This is especially important if you are taking diabetes medicines or blood thinners.
  • Taking medicines such as aspirin and ibuprofen. These medicines can thin your blood. Do not take these medicines unless your health care provider tells you to take them.
  • Taking over-the-counter medicines, vitamins, herbs, and supplements.
• Plan to have someone take you home from the hospital or clinic.
• Plan to have a responsible adult care for you for at least 24 hours after you leave the hospital or clinic. This is important.
• Ask your health care provider how your surgical site will be marked or identified.
• You may be asked to shower with a germ-killing soap.
• You may be given antibiotic medicine to help prevent an infection.

What happens during the procedure?

• To lower your risk of infection:
  • Your health care team will wash or sanitize their hands.
  • Hair may be removed from the surgical area.
  • Your skin will be washed with soap.
• An IV will be inserted into one of your veins.
• You will be given one or more of the following:
  • A medicine to help you relax (sedative).
  • A medicine to numb the area (local anesthetic).
  • A medicine to make you fall asleep (general anesthetic).
  • A medicine that is injected into your spine to numb the area below and slightly above the injection site (spinal anesthetic).
  • A medicine that is injected into an area of your body to numb everything below the injection site (regional anesthetic).
• The surgeon will make an incision through your skin over the area of the fracture.
• The broken bones will be returned to their normal positions. The surgeon will use screws and a metal plate or different types of wiring to hold the bones in place.
• The surgeon will close the incision with stitches (sutures) or staples.
• A bandage (dressing) will be placed over your incision.
• A shoulder immobilizer may be placed to keep your arm in position.

The procedure may vary among health care providers and hospitals.

What happens after the procedure?

• Your blood pressure, heart rate, breathing rate, and blood oxygen level will be monitored until the medicines you were given have worn off.
• You will be given medicine for pain as needed.
• You may have physical therapy while you are in the hospital.
• You may be sent home with a sling to support your arm.
• Do not drive for 24 hours if you were given a sedative during your procedure.

Summary

• A humerus fracture is a break in the upper arm bone (humerus).
• To repair this fracture with ORIF, your surgeon will make an incision over the bone then move parts of the bone back into the right position.
• A combination of screws, metal plates, and other types of hardware will be used to hold the parts of the bone in place.
• The incision will be closed with stitches (sutures) or staples, and a bandage (dressing) will be placed over it.
• You may be sent home with a sling to support your arm.

Humerus Fracture Treated With ORIF, Care After

This sheet gives you information about how to care for yourself after your procedure. Your health care provider may also give you more specific instructions. If you have problems or questions, contact your health care provider.

What can I expect after the procedure?

After the procedure, it is common to have:

• Pain.
• Swelling.
• Stiffness.
• Small amount of fluid from the incision.

Follow these instructions at home:

Bathing

• Do not take baths, swim, or use a hot tub until your health care provider approves. Ask your health care provider if you can take showers. You may only be allowed to take sponge baths.
• If your sling or immobilizer is not waterproof, cover it with a watertight covering when you take a bath or a shower.
• Keep the bandage (dressing) dry until your health care provider says it can be removed.

If you have a sling or a shoulder immobilizer:

• Wear the sling or immobilizer as told by your health care provider. Remove it only as told by your health care provider.
• Loosen the sling or immobilizer if your fingers tingle, become numb, or turn cold and blue.
• Keep the sling or immobilizer clean.
• If the sling or immobilizer is not waterproof:
  • Do not let it get wet.
  • Cover it with a watertight covering when you take a bath or a shower.

Incision care

• Follow instructions from your health care provider about how to take care of your incision. Make sure you:
  • Wash your hands with soap and water before you change your dressing. If soap and water are not available, use hand sanitizer.
  • Change your dressing as told by your health care provider.
  • Leave stitches (sutures), skin glue, or adhesive strips in place. These skin closures may need to stay in place for 2 weeks or longer. If adhesive strip edges start to loosen and curl up, you may trim the loose edges. Do not remove adhesive strips completely unless your health care provider tells you to do that.
• Check your incision area every day for signs of infection. Check for:
  • Redness.
  • More swelling or pain.
  • Blood or more fluid.
  • Warmth.
  • Pus or a bad smell.

Managing pain, stiffness, and swelling

• If directed, put ice on the affected area.
  • Put ice in a plastic bag or use the icing device (cold therapy unit) that you were given. Follow instructions from your health care provider about how to use the icing device.
  • Place a towel between your skin and the bag or icing device.
  • Leave the ice or icing device on for 20 minutes, 2–3 times a day.
• Move your fingers often to avoid stiffness and to lessen swelling.
• If told by your health care provider, raise (elevate) the injured area above the level of your heart while you are sitting or lying down. To do this, try putting a few pillows under your arm.

Driving

• Do not drive or use heavy machinery while taking prescription pain medicine.
• Ask your health care provider when it is safe to drive if you have a sling or immobilizer.

Activity

• Return to your normal activities as told by your health care provider. Ask your health care provider what activities are safe for you.
• Do exercises as told by your health care provider.
• Do not lift with your injured arm until your health care provider approves.
• Avoid pulling and pushing.
• Follow instructions from your health care provider about:
  • Whether you may gently use your hand and elbow immediately after surgery.
  • When to start doing gentle range of motion movements with your shoulder and elbow. It is important to do these movements to prevent loss of motion.

General instructions

• Take over-the-counter and prescription medicines only as told by your health care provider.
• Do not use any products that contain nicotine or tobacco, such as cigarettes and e-cigarettes. These can delay bone healing. If you need help quitting, ask your health care provider.
• If you are taking prescription pain medicine, take actions to prevent or treat constipation. Your health care provider may recommend that you:
  • Drink enough fluid to keep your urine pale yellow.
  • Eat foods that are high in fiber, such as fresh fruits and vegetables, whole grains, and beans.
  • Limit foods that are high in fat and processed sugars, such as fried or sweet foods.
  • Take an over-the-counter or prescription medicine for constipation.
• Keep all follow-up visits as told by your health care provider. This is important.

Contact a health care provider if:

• You have pain that is not helped by medicine.
• You have a fever.
• You have redness around your incision.
• You have more swelling or pain around your incision.
• You have blood or more fluid coming from your incision.
• Your incision feels warm to the touch.
• You have pus or a bad smell coming from your incision or your dressing.
• You feel faint or light-headed.
• You develop a rash.

Get help right away if:

• The edges of your incision come apart after the stitches or staples have been taken out.
• You have trouble breathing.
• You have numbness or tingling in your hand or fingers.

Summary

• After this procedure, it is common to have some pain, swelling, or stiffness.
• If your sling or immobilizer is not waterproof, do not let it get wet.
• Contact your health care provider if you have blood or more fluid coming from your incision.
• Get medical help right away if you have numbness or tingling in your hands or fingers.