Open Reduction of the Humerus

Definition

Realignment and fixation of a fracture of the arm necessitating an operative incision.

Discussion
  • A variety of fractures of the humerus may occur.
  • If closed reduction and immobilization are unsatisfactory or when there is nounion, fixation may be achieved by using a number if internal fixation devices, including screws, rods, and compression plates.

ORIF

Positioning
  • Supine, affected arm in comfortable position, unaffected arm extended on an armboard.
Packs/ Drapes
  • Extremity pack with fenestrated sheet
  • Impervious stockinette
  • Eshmarch bandage
  • Towels
  • Split sheet
Instrumentation
  • Basic orthopedic tray
  • Soft tissue tray
  • Drill bits
  • Retractors
  • Fixation device
  • Screws/ plates
  • Compression set
  • Power drill
  • Cord
Supplies/ Equipment
  • Basin set
  • Suction
  • Power source for drill
  • Tourniquet
  • Insufflator
  • Sheet wadding
  • Casting materials
  • Blades
  • Needle counter
  • Sutures
  • Solutions
  • Medications
Procedure Overview
  1. An appropriate incision is made over the fracture site, avoiding neurovascular structures.
  2. If malunion has occurred, an osteotomy (cutting through a bone) is performed to restore alignment.
  3. Fixation is performed with screws and a compression plate.
  4. For condylar fractures, a threaded Kirschner (K) wires or screws may be used.
  5. The wound is irrigated and closed; the arm is immobilized.
Perioperative Nursing Interventions
  1. Have X-ray capabilities in the room
  2. Be prepared to assist the surgeon in applying a cast or splint.
  3. Check tank levels for power equipment before beginning the procedure.
  4. Have adequate help to hold up and stabilize arm during prepping and draping procedure.
  5. If distal fracture (near wrist), a hand table (side extension table) may be used.
Announcement!! Our hottest nursing game is out now in the App Store. Many nurses are playing now!LEARN MORE
+