Steps of open reduction and internal fixation for ankle fracture
Mar 15, 2023
Source: Cainiu Health
Dr. Xu Shuai
Introduction
The patient was positioned laterally for anesthesia administration, then turned to a supine position on the operating table. After the anesthesia took effect, the surgeon made an incision starting from the lateral malleolus along the direction of the fibula. A retractor was used to open the incision, allowing assessment of fracture displacement. The fractured fragments were reduced, and a cannulated compression screw was inserted across the fracture line through pre-drilled holes for fixation. A plate and screws were additionally applied at the lateral aspect of the fracture site for stabilization. Finally, the incision was sutured and the operation was completed.
Open reduction and internal fixation (ORIF) for ankle fractures is primarily indicated for cases where manual reduction is difficult or unsuccessful. This procedure should be performed in a正规 hospital setting. The specific steps are as follows:
1. The patient is placed in a lateral decubitus position, and the anesthesiologist administers anesthesia at the L3-L4 vertebral interspace.
2. After injection of the anesthetic agent, the surgeon instructs the patient to lie supine on the operating table. A tourniquet is then applied at the upper one-third of the thigh, followed by routine disinfection and draping of the ankle joint area.
3. Once anesthesia takes effect, the surgeon makes an 8–10 cm incision along the fibular aspect of the lateral malleolus and dissects through layers until the fracture site is exposed. A retractor is used to open the incision, allowing assessment of the direction of fracture displacement.
4. Bone forceps are used to reduce the fractured fragments, and a cannulated compression screw is inserted across the fracture line after drilling.
5. A plate and screws are applied laterally at the fracture site for additional fixation. The incision is then sutured closed, completing the surgery.
Postoperatively, the diet should be light, avoiding sour, spicy, hot, greasy, and tonifying foods.
