Understanding Upper Arm Fracture Open Reduction and Internal Fixation (ORIF)

Open reduction and internal fixation (ORIF) is done to fix a broken bone. It puts the pieces of a broken bone back together so they can heal. Open reduction means the bones are put back in place during surgery. Internal fixation means that special hardware is used to hold the bone pieces together. This helps the bone heal correctly. The procedure is done by an orthopedic surgeon. This is a healthcare provider with special training in treating bone, joint, and muscle problems.

How an arm fracture happens

The humerus is the bone in the upper part of your arm. An injury may cause it to break (fracture) into 2 or more pieces. Your humerus may be broken near your shoulder, in the middle of your upper arm, or near your elbow. The humerus can break with the pieces lined up correctly. Or the pieces of bone may not be lined up correctly. This is called a displaced fracture.

Why arm fracture ORIF is done

You are likely to need ORIF if:

  • You have a displaced fracture

  • Part of your humerus broke through the skin

  • Your humerus broke into several pieces

How arm fracture ORIF is done

The surgery can be done in several ways. The surgeon will make a cut (incision) through the skin and muscles of your arm. Or an incision will be made on the top of the shoulder. The surgeon puts the pieces of your humerus back in place. This is the reduction. Then special screws, plates, wires, or pins are used to hold the bone pieces together. This is the fixation. For a fracture in the middle of your upper arm, a special metal nail may be put through the middle of the bone. It screws into the bone at both ends.

Risks of arm fracture ORIF

All surgery has risks. The risks of arm fracture ORIF include:

  • Damage to the shoulder or elbow joint from screws

  • Broken screws or plates

  • Infection

  • Bleeding

  • Nerve damage

  • Death of part of the humerus (avascular necrosis)

  • Loss of movement

  • Misaligned bone

  • Bones don't join and heal (nonunion)

  • Need for additional surgery

  • Problems from anesthesia

Your risks vary based on your age and general health. For example, if you are a smoker or if you have low bone density, you may have a higher risk for certain problems. People with diabetes may also have a higher risk for problems. Talk with your healthcare provider about which risks apply most to you.