INTRODUCTION

An open reduction internal fixation (ORIF) refers to a surgical procedure to fix a

severe bone fracture or break. Open reduction means surgery is needed to realign the bone
fracture into the normal position. Internal fixation refers to the steel rods, screws, or plates
used to keep the bone fracture stable in order to heal the right way and to help prevent infection.
Open reduction internal fixation can also refer to the surgical repair of a joint, such as a hip
or knee replacement.
The surgical procedure is performed by a doctor who specializes in orthopedics, which is a
branch of medicine concerning the musculoskeletal structure of the body. Under general
anesthesia, an incision is made at the site of the break or injury, and the fracture is carefully realigned or the joint replaced. The hardware is installed, and the incision is closed with staples or
stitches. The steel rods, screws, or plates can be permanent or temporary and removed when
healing takes place.
Once the open reduction internal fixation is performed, a cast is usually applied. In the case of an
ankle fracture, for instance, the first cast is a non-weight bearing cast, and crutches can be used
to help keep weight off the healing bones. Later, when the healing has progressed, this cast will
be replaced with one that can bear weight. Eventually, after a period of some weeks, the cast will
be removed entirely.

CONS OF ARTHROSCOPY
Risks and complications can include bacterial colonization of the bone, infection,
stiffness and loss of range of motion, non-union, malunion, damage to the muscles, nerve
damage and palsy, arthritis, tendonitis, chronic pain associated with plates, screws, and pins,
compartment syndrome, deformity, audible popping and snapping, and possible future surgeries
to remove the hardware.

RECOVERY RATE AND PROCESS OF ORIF SURGERY

Recovery from a bone fracture after an open reduction internal fixation can be quite
painful, and pain management becomes a concern. Commonly, acetaminophen with codeine is
prescribed, as research has shown ibuprofen or other non-steroid anti-inflammatory drugs
(NSAIDs) may slow down or inhibit the rate of healing. It is important to take the drugs as
prescribed to help manage the pain cycle.
Physical therapy is also an important part of the recovery process after an open reduction
internal fixation. Since the part of the body that has been injured is usually held still or
immobilized for a long period of time, the muscles, tendons, and ligaments can become weak.
Physical therapy helps to restore the strength, range of motion, and endurance of the affected
area. It can also help with pain management. Physical therapy can consist of exercises, hot or
cold packs, ultrasound, and nerve stimulation, or a combination of treatments.

ORIF SURGERY COMPLICATIONS

Complications of ORIF can include infection, swelling, and movement of the installed
hardware. The recovery process can take months, because bones grow slowly. Other factors that
can affect recovery are the location and severity of the break, the age of the person, and the type
of bone broken.

Patellar fractures account for about 1% of all fractures. They are most common in people
who are 20 to 50 years old. Men are twice as likely as women to fracture the kneecap.
In the Philippines, current data from the national health insurance system recorded 27,340
fractures (non-hip, non-spine) from 20072012 in individuals aged 50 years and older. Previous
data from 2003 National Nutrition and Health Survey (NNHES) indicated the overall prevalence
of fragility factures was 11.23% in women and 8.97% in men.
Patient accidentally fell off his bicycle and hit his right knee on the ground, resulting in
right patellar fracture in which ORIF Surgery was performed at UERM Hospital last January 23,
2016.

GORDONS FUNCTIONAL HEALTH PATTERN

GORDONS

BEFORE

DURING

NURSING

FUNCTIONAL

HOSPITALIZATION

HOSPITALIZATION

DIAGNOSIS

ASSESSMENT
Health Perception -

S > Huminto na ako sa

S> Ganun pa rin naman,

Readiness for

Health Management

paninigarilyo. Bihira

walang pinagbago.

enhanced self-

Pattern

lang ako uminom,

Iniinom ko yung mga

health

tuwing may okasyon

gamot ko sa tamang oras. management

lang. Bihira lang ako

as verbalized.

magkasakit sa loob ng

O> Client has compliance

isang taon. Sa tuwing

with medication regimen.

nagkakasakit ako,
umiinom agad ako ng
gamot at nagpapahinga.
May allergy ako sa
penicillin. As
verbalized.
O> Client is a previous
smoker, stopped 15 years
ago. He drinks alcoholic
beverages occasionally.
He has compliance with
medication regimen and
uses health promotion

activities. He has
allergy with penicillin,
Nutritional -

aspirin and amoxicillin.

S> Tatlong beses akong

S> Wala namang

Readiness for

Metabolic Pattern

kumakain sa loob ng

pinagbago. Tatlong beses

enhanced

isang araw. Kanin, gulay

pa rin naman ako

nutrition

at isda ang madalas kong

kumakain sa loob ng isang

mga kinakain. Mahilig

araw at mahilig pa rin ako

din akong uminom ng

uminom ng tubig. as

tubig. as verbalized.

verbalized.

O> Client eats 3x a day

O> Client eats 3x a day

with snacks in between.

and drinks at least 8

He drinks at least 8

glasses of water.

glasses of water a day.

S> Mahilig ako

S> Ganun pa rin ang

Readiness for

uminom ng tubig kaya

pag-ihi ko walang

enhanced

Elimination Pattern

madalas din ako umihi sa pinagbago. Regular pa rin

urinary

loob ng isang araw. Mga

ang pagdumi ko. as

elimination

5-6 na beses. Regular

verbalized.

naman ang pagdumi ko.

O> Client voids 5-6x a

as verbalized.

day. He experiences no

O> Client voids 5-6x a

pain during urination.

day. He experiences no

Regular bowel movement.

pain during urination.

Regular bowel
Activity - Exercise

movement.
S> Nagba-bike ako

S> Nakahiga lang ako

Impaired

Pattern

every day, mga 20

dito sa kama. Hindi ko

physical

minutes every morning.

masyadong ginagalaw

mobility

Yun na ang exercise ko.

yung paa ko kasi

As verbalized.

kumikirot. Inaalalayan

O> Client uses his

naman ako ng asawa ko sa

bicycle every morning as

tuwing may kailangan

a form of exercise.

ako. As verbalized.

O> Client is ambulatory

Sleep Rest Pattern

S> Maayos naman ang

with assistance.
S> Hindi ako

Disturbed

tulog ko. Nakakatulog

masyadong nakakatulog

sleep pattern

naman ako ng walong

ng maayos dito. Mainit

oras sa loob ng isang

kasi tapos minsan

araw. As verbalized.

kumikirot-kirot din

O> Client has good

yung tuhod ko.

sleeping pattern. He

O> Patient has

sleeps at 8pm-4am.

intermittent sleep due to

environmental factors.

Cognitive -

S> Malabo yung mga

S> Ganun pa rin. naman.

Acute pain

Perceptual Pattern

mata ko. Wala naman

Kumikirot-kirot yung

akong problema sa

tuhod ko. as verbalized.

Disturbed

pandinig. as verbalized.

Pain Scale of 5/10

sensory

O> Patient has

O> Patient has impaired

perception

impaired vision. Visual

vision. Visual acuity of

acuity of 175 on the

175 on the right eye and

right eye and 145 on

145 on the left eye. There

the left eye. There is no

is no lateralization of

lateralization of sound

sound heard on both ears.

Self-Perception - Self

heard on both ears.

S> Masayahin akong

S> Isa sa mga concern

Concept Pattern

tao. Magaling akong

ko, sana makabalik pa

makisama sa kapwa.

ako sa dati. as

Kuntento na ko sa mga

verbalized.

Anxiety

bagay na meron ako

ngayon. as verbalized.

O> Client has worried

expressions.

O> Client has fair

economic status and
Role - Relationship

contented with his life.

S> Kasama ko sa bahay

S> Binabantayan ako ng

Readiness for

Pattern

ang asawa ko at mga

asawa ko dito sa ospital,

enhanced

anak ko. Maayos naman

tapos dinadalaw ako ng

family

ang samahan naming

mga anak ko. as

lahat. as verbalized.

verbalized.

processes

O> Client is married. He

has a good relationship

O> Client has good

with his family.

relationship with his

Sexuality -

S> Wala naman akong

family.
S> Ganun pa rin. as

Reproductive Pattern

history ng STD at hindi

verbalized.

N/A

kami gumagamit ng
contraceptives. as

O> Client has no history

verbalized.

of STDs and has low

libido.

O> Client has no history

of STDs and has low
Coping - Stress

libido.
S> Hindi naman ako

S> Nandito naman ang

Pattern

madamdamin na tao.

asawa ko para alagaan ako compromised

Bihira ako ma-stress.

kaya hindi naman ako

Pero ang ginagawa ko

naiistress. Ang iniisip ko

kapag na stress ako,

lang talaga ay kung

nagdadasal ako.

makakabalik pa ako sa

Pinapaubaya ko sa Diyos

dati. As verbalized.

ang lahat ng problema

O> Client is worried if

ko. Siya lang kasi ang

he will recover from his

Risk for

resilience

makakatulong sakin. As

pre-accident state.

verbalized.
O> Client has good
coping skills. He usually
Value - Belief Pattern

pray to manage stress.

S> Katoliko ako.

S> Wala namang

Readiness for

Naniniwala ako sa

pagbabago sa paniniwala

enhanced

Diyos. Nagdadasal ako

ko sa Diyos.

religiosity

palagi. as verbalized.

O> Client is religious and

O> Client is religious

has a strong faith in God.

and has a strong faith in

God.