Ace Physiotherapy and Sports in Singapore
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ORIF Elbow
Open Reduction and Internal Fixation (ORIF) of the elbow is a surgical procedure used to treat elbow fractures. Open reduction involves surgically exposing and realigning the broken bones to their correct anatomical position, which is necessary for fractures that cannot be treated with a cast alone. Internal fixation involves securing the bones with screws, pins, wires, and/or plates to hold them in place and promote proper healing, ensuring stability and restoring function to the elbow joint.
The elbow joint is formed by the distal end of the humerus (upper arm bone) and the proximal ends of the ulna and radius (forearm bones). The ulna is the larger forearm bone on the side opposite the thumb, while the radius is smaller and located on the same side as the thumb. Elbow fractures typically occur due to direct trauma or a fall onto an outstretched hand. In this position, the elbow absorbs a large amount of force, making it highly vulnerable to fractures. During such falls, approximately 60% of body weight is transmitted to the elbow, with the radial head particularly at risk. Underlying conditions such as osteoarthritis further increase the risk of fracture after trauma.
Elbow fractures may involve different parts of the joint. They can occur at the distal end of the humerus (upper arm bone), the proximal end of the ulna (larger forearm bone), or the proximal end of the radius (smaller forearm bone near the elbow). In some cases, fractures may affect multiple parts of the elbow joint simultaneously, involving a combination of these articulations.
A fracture to the elbow can vary in severity and type. It may be non-displaced, where the bone fragments remain in their proper position, or displaced, where the fragments are out of alignment. Some fractures are comminuted, meaning the bone is broken into three or more pieces, and others may occur in combination with an elbow dislocation. Treatment depends on the type and severity of the fracture. Non-displaced or minimally displaced fractures may be managed conservatively without surgery, while significantly displaced or comminuted fractures typically require Open Reduction and Internal Fixation (ORIF) to realign and stabilize the bones, ensuring proper healing and restoring function in the elbow joint.
During an ORIF (Open Reduction and Internal Fixation) of the elbow, the surgical approach and incision depend on the specific structures involved in the fracture. Once the site is exposed, the fractured bone ends are carefully realigned—a process known as open reduction. Internal fixation is then performed using a combination of pins, screws, and wires to securely hold the bones in place, facilitating proper healing. Prompt surgical intervention after a displaced elbow fracture is essential to reduce pain, promote optimal healing, restore joint function, and prevent further complications or injuries in the future.
Physiotherapy is essential once the fracture site has healed sufficiently, as it maximises the success of ORIF surgery and helps restore full or near-to-full function in the elbow joint and the entire upper limb.
Symptoms after ORIF surgery
After ORIF of your elbow, you can expect pain, swelling, stiffness, and a reduced range of movement. There will also be a loss of function along with decreased muscle strength and control. A removable cast will be worn for the first 3 to 6 weeks, and a sling will be provided for protection and support during the early stages of recovery. You will be discharged from the hospital once you are comfortable and ready. Physiotherapy should begin as soon as possible to promote a rapid and complication-free recovery, although intensive physiotherapy cannot start until the fracture site has sufficiently healed. Driving will typically be restricted for up to 6 weeks after surgery.
Physiotherapy after ORIF elbow
Immediate physiotherapy is crucial following ORIF of your elbow to help reduce pain, swelling, and stiffness, while restoring some range of movement. After discharge from the hospital, ongoing physiotherapy with Physio.co.uk is essential to maximise the success of the surgery, regain as much function as possible in your elbow, and minimise the risk of future complications.
Week 1
In the initial period after your ORIF elbow, your elbow will be placed in a removable cast (90° flexion, neutral rotation), which can be taken off for exercises and then replaced afterward. The cast may also be worn at night for up to 6 weeks. Physiotherapy typically begins during the first week after ORIF elbow surgery and initially focuses on controlling pain and swelling, while maintaining mobility and range of movement. Early physiotherapy also targets strengthening and improving function in your wrist, shoulder, and unaffected upper limb to provide optimal support.
- Control pain and swelling in and around the elbow joint
- Maintain mobility and range of movement in the elbow
- Improve strength and function in the wrist, shoulder, and unaffected upper limb for support
Week 1-4
After a week of recovery post-ORIF elbow surgery, your physiotherapy with Physio.co.uk will continue to focus on controlling pain and swelling. The programme will aim to reduce stiffness in your elbow joint and progressively increase your range of movement—from passive (assisted) exercises to active (self-directed) exercises. At this stage, you will also be provided with an independent home exercise programme to maximise your rate of recovery.
- Control pain and swelling in the elbow joint
- Reduce stiffness in the elbow
- Increase passive (assisted) range of movement
- Progress to active (self-directed) range of movement
- Follow an independent home exercise programme to maximise recovery
Week 5-8
During the second month of your rehabilitation after ORIF elbow surgery, your physiotherapy will continue to build on the activities from previous weeks. The focus will remain on reducing pain, swelling, and stiffness while increasing flexibility and both passive and active range of movement in your elbow joint. Your physiotherapy programme with Physio.co.uk will also progress to strengthening the muscles around your elbow, while continuing exercises to improve strength in your wrist, shoulder, and unaffected arm to achieve maximum overall function. Depending on your progress, mobilisation techniques and gentle cardiovascular activities may also be incorporated into your rehabilitation at this stage.
- Continue reducing pain, swelling, and stiffness in the elbow
- Increase flexibility and passive/active range of movement
- Strengthen muscles around the elbow joint
- Continue strengthening wrist, shoulder, and unaffected arm
- Incorporate mobilisation and gentle cardiovascular activities depending on progress
Week 9-12
After 8 weeks of successful rehabilitation with Physio.co.uk, you will have seen significant improvements in strength, range of movement, and function within your elbow joint. Your physiotherapy programme will continue to focus on maximising mobility and range of movement in your elbow, while also increasing strength and muscle control in the muscles around your affected elbow, wrist, shoulder, and unaffected arm. At this stage, it is also important for your physiotherapy to include activities that help prevent scar tissue adhesions within the elbow joint following your ORIF surgery. Additionally, after 2 months of rehabilitation, your physiotherapy goals will include improving cardiovascular fitness, muscle endurance, and performing activities specific to your everyday tasks, job, hobby, or sport.
- Maximise mobility and range of movement in the elbow
- Increase strength and muscle control in the affected elbow, wrist, shoulder, and unaffected arm
- Prevent scar tissue adhesions within the elbow joint
- Improve cardiovascular fitness and muscle endurance
- Perform activities specific to everyday tasks, job, hobby, or sport
After about 3 months of successful physiotherapy with acephysiosports.com, you should have regained full and painless function in your elbow. At this stage, your rehabilitation will focus on activity- and sport-specific exercises, allowing you to begin jogging and participate in more physically demanding activities. The overall success and speed of your recovery after ORIF elbow surgery will depend on your commitment to the physiotherapy programme and the extent of your initial injury.
Summary
Open reduction and internal fixation (ORIF) of the elbow is a surgical procedure to treat a fractured part of the elbow joint. It involves realigning the fractured segments and securing them using screws or pins. ORIF is necessary for displaced (out of position) or comminuted (three or more fragments of bone) fractures to stabilise and correct the injury. If the fracture is non-displaced and remains in position, a conservative (non-surgical) physiotherapy approach may be recommended. ORIF surgery is essential as it reduces pain and swelling and lowers the risk of long-term damage or loss of function in the elbow. Physiotherapy is critical immediately after ORIF elbow surgery to ensure the success of the procedure, reduce pain and stiffness, aid in fracture healing, and improve range of movement. A personalised physiotherapy programme with acephysiosports.com will help you regain full or near to full function in your elbow and return to the activities you enjoy as soon as possible. Call acephysiosports.com on +65 81535374 for more information or to book an appointment.
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