Day Surgery Leaflet: Open Reduction and Internal Fixation (ORIF) of Radius / Ulna

Open Reduction and Internal Fixation (ORIF) of Radius / Ulna: You will be going home on the day of your surgery after you are able to eat and drink and have passed urine. You would stay in the hospital for a minimum of one to two hours for observations. You will need a responsible adult to pick you up from the hospital and stay with you overnight.

Leaflet Details

Patient Information

After your surgery

• You will be going home on the day of your surgery after you are able to eat and drink and have passed urine. You would stay in the hospital for a minimum of one to two hours for observations. You will need a responsible adult to pick you up from the hospital and stay with you overnight.

Dressings

• You will have bulky dressings on your arm over your skin dressings. You may also have a plaster cast (either a full or half cast) under the bulky dressings. You need to keep these dry and intact until you are seen in the clinic.
   
• If you do not have a plaster cast, you can remove the bulky dressings after 72 hours and change the skin dressing at the same time. These dressings will need to stay until seen in clinic or as instructed on your discharge.
   
• You will be given a sling to use for 2-3 days for comfort. After this time, you can remove the sling and you should be able to move your arm but avoid any heavy lifting. If the surgery was done near your wrist, it is important not to use this arm for any lifting at all. You will be advised on discharge.

Exercises

• You can start doing finger exercises on the day of your surgery; if you have been given a nerve block (local anaesthetic injection to numb your arm), you can start these as soon as the movement comes back.
   
• You should be able to do full range of motion movements as soon as you are able to do so. Any restrictions will be discussed with you before you leave the hospital. If necessary, you may be advised by a physiotherapist for any specific exercises.

Stitches

You will have stitches to close the wound.

• Dissolvable stitches can take a few weeks/months to dissolve.
   
• Non-dissolvable stiches need to be removed in 2 weeks’ time. This will be done either during your outpatient appointment or the practice nurse in your GP surgery; you will need to make an appointment for the practice nurse.

Wound care

• You will experience bruising and swelling on your fingers/hand. This should settle down after a few days. You need to keep your arm elevated for 48-72 hours to keep it from swelling.
   
• If you notice any bleeding through the dressings, please apply firm pressure over it for about 15-20 minutes. If the bleeding does not stop, please go to your nearest A and E department.

Pain

• It is common to have pain on the area. Please take regular pain relief until this wears off.

Activities

• You need to take it easy for a few days. You are advised to take short walks the day after surgery, slowly building up to your normal activities.
   
• You should not drive until seen in clinic. It is advisable to check with your insurance company as they may have different policies.
   
• Providing that your job does not involve physical exertion, you may return to work as soon as you feel able to do so. Most people feel ready to return to work within 2-3 weeks.

Blood clot prevention

• It is important that you resume normal activities as advised and keep active. You must wear the anti-embolic stockings given to you for 7 days, both during the day and at night. They can be removed while you have a shower and applied again afterwards.
   
• You may have been given a blood thinning injection either during or after surgery. These help prevent blood clots such as in the leg (deep vein thrombosis) or the lung (pulmonary embolus). Depending on your medical risk factors, you may need to have this injection for a few days at home. You will be given instructions on how to administer them by your nurse.

Follow up appointment

• You will have a follow-up appointment in the outpatient clinic after 2-3 weeks. An appointment letter will be sent to you with the details by the orthopaedic office.

What to watch out for:

Please contact your GP if:

• Your arm / hands feels inflamed, hot to touch and you have a temperature as these can be signs of infection
   
• If you need further pain relief

Please contact Rowley Bristow clinic or attend Accident and Emergency department if:

• There is significant swelling on your arm and the dressings feels extremely tight
   
• The sensation on your fingers changes i.e. it becomes numb, very painful or extremely cold
   
• The colour of your fingers changes i.e. becomes very pale or blue tinged
   
• The pain becomes severe and unmanageable
   
• The bleeding from the wound becomes excessive and uncontrolled

Useful contact numbers:

• Day Surgery Unit Ashford hospital 01784 884609 or 01784 884189 between 8am-9pm Monday to Friday
   
• Dickens ward 01784 884004 or Swan ward 01932 723220 after 9pm weekdays, all day weekends and bank holidays
   
• Orthopaedic office / Rowley Bristow Clinic 01932 722730 for appointment queries

If you feel unwell and needed urgent medical care, please go to your nearest Accident and Emergency Department immediately and bring your discharge letter with you.