✦ Minimally Invasive Fixation

CRIF — Closed Reduction & Internal Fixation

Q: What is CRIF surgery?

CRIF is closed reduction of a fracture (without opening the skin) followed by internal fixation using K-wires, screws, or nails inserted through small stab incisions under fluoroscopic guidance.

Q: What is CRIF with PFN procedure?

In intertrochanteric hip fractures, a proximal femoral nail (PFN) is inserted through a small hip incision after closed reduction on a traction table — providing stable fixation without opening the fracture site.

Q: When is CRIF preferred over ORIF?

CRIF is preferred when closed reduction achieves an acceptable position and the fracture can be stabilised percutaneously — typically for hand fractures, distal radius fractures, and hip nail procedures.

The fracture is reduced without opening the skin — using traction and X-ray guidance — then stabilised with percutaneously inserted implants, minimising soft tissue disruption, infection risk, and scarring.

30–75 min PROCEDURE

1–3 Days HOSPITAL STAY

>92% UNION RATE

Lower than ORIF INFECTION RISK

What is CRIF — Closed Reduction & Internal Fixation?

CRIF (Closed Reduction and Internal Fixation) combines the advantages of internal fixation with a minimally invasive, closed technique. The fracture is reduced using traction, manual manipulation, and fluoroscopic (X-ray) guidance — without opening the fracture site — and then stabilised with implants (K-wires, cannulated screws, or intramedullary nails) inserted through small stab incisions in the skin. By avoiding a large incision over the fracture, CRIF preserves the fracture haematoma, periosteal blood supply, and local soft tissue envelope that are critical to bone healing — resulting in lower infection rates and often faster union compared to open techniques.

Suitable for fractures where the anatomy allows closed reduction to an acceptable position under fluoroscopic control — most commonly metacarpal, phalangeal, distal radius, intertrochanteric hip fractures (CRIF with PFN), and many paediatric fractures where open surgery is avoided wherever possible.

How the Procedure Works

Fracture Reduction

The fracture is reduced manually or with traction under continuous fluoroscopic guidance — no incision over the fracture site.

Fluoroscopic Confirmation

Reduction quality is confirmed in two planes on X-ray before any implant is inserted.

Percutaneous Implant Insertion

K-wires, cannulated screws, or an intramedullary nail are inserted through small stab incisions under fluoroscopic guidance.

Final Position Check

Definitive fluoroscopic images confirm implant position and fracture alignment before wound closure.

Mobilisation

Early mobilisation begins; K-wires are removed in clinic at 4–6 weeks; nails remain until union is confirmed.

Outcomes

30–75 minDURATION

1–3 DaysHOSPITAL STAY

>92%UNION RATE

LowerINFECTION RISK VS ORIF

Who Needs This Treatment?

→No incision over the fracture — biology of fracture healing is preserved
→Lower infection risk than open reduction
→Smaller scars — percutaneous stab incisions only
→Shorter procedure time than equivalent ORIF
→Rapid post-operative mobilisation
→K-wire removal performed as a simple clinic procedure under local anaesthesia

"Closed reduction preserves something very important — the natural healing environment around the fracture. When we can reduce a fracture without opening it and fix it with percutaneous implants, we give the bone the best possible conditions to heal quickly and reliably."

— Dr. Satish Reddy Gandavarapu, Senior Orthopaedic & Trauma Surgeon, Lux Hospitals, Hyderabad

Common Questions

Frequently Asked

What is CRIF surgery?+

What is CRIF with PFN procedure?+

When is CRIF preferred over ORIF?+

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