CRIF (Closed Reduction & Internal Fixation)
A fracture is realigned without opening the skin and stabilised with implants inserted through small incisions under continuous X-ray guidance — combining the biological advantage of closed reduction with the stability of internal fixation.
What is CRIF (Closed Reduction & Internal Fixation)?
Closed Reduction and Internal Fixation (CRIF) avoids making a surgical incision over the fracture site — instead, the fracture is manipulated into position through the skin under fluoroscopic guidance, and fixation implants (screws, wires, or nails) are introduced percutaneously through small stab incisions. This preserves the periosteal blood supply and the soft tissue envelope around the fracture — biological factors that favour faster and more reliable bone healing compared to formal open dissection. Dr. Sai Kishan applies CRIF as part of his AO Trauma Certified approach to fracture management at Lux Hospitals, selecting it when the fracture can be adequately reduced indirectly and fixed without direct surgical exposure.
Appropriate for fractures that can be satisfactorily reduced without direct exposure — including distal radius fractures, selected ankle fractures, paediatric physeal injuries, and some proximal femur fractures — where percutaneous implant placement can achieve acceptable fixation without the tissue disruption of formal open surgery.
How the Procedure Works
Anaesthesia & Fluoroscopy Setup
General, regional, or local anaesthesia; a C-arm fluoroscope provides real-time X-ray imaging throughout the reduction and fixation process.
Closed Fracture Reduction
The fracture is manipulated into its correct position using traction and controlled manual manoeuvres; fluoroscopy confirms adequate reduction in all planes.
Percutaneous Implant Placement
Through small stab incisions, K-wires, screws, or an intramedullary nail are placed across the fracture under continuous fluoroscopic guidance.
Fixation Quality Confirmation
Multiple fluoroscopic projections confirm satisfactory hardware position, fracture alignment, and fixation stability before the procedure is completed.
Wound Closure & Immobilisation
Small stab incisions are closed; an external cast or splint may supplement the fixation depending on fracture characteristics and stability achieved.
Outcomes
Who Needs This Treatment?
- →
Preserves the biological healing environment by avoiding fracture site dissection
- →
Achieves internal fixation stability through percutaneous implant delivery
- →
Lower infection risk than open surgery — smaller incisions and less tissue disruption
- →
Fluoroscopic guidance ensures precise implant placement without direct visualisation
- →
Suitable for a broad range of fracture patterns across multiple anatomical sites
- →
Often performable as a short-stay or day-case procedure
CRIF gives us fixation stability without sacrificing biology — you avoid stripping the soft tissue envelope that the fracture's healing depends on. That biological preservation translates directly into faster, more reliable bone healing.
— — Dr. Sai Kishan Sirasala, Knee and Hip Joint Replacement & Robotic Surgery
CRIF (Closed Reduction & Internal Fixation) Cost in Hyderabad
The cost of CRIF (Closed Reduction & Internal Fixation) in Hyderabad generally ranges from ₹50,000 to ₹1,20,000, with an average estimated cost of ₹85,000. CRIF is a minimally invasive fracture treatment in which the bone is aligned through a closed reduction and stabilized using internal fixation devices, often through small incisions. The final cost depends on the fracture location and pattern, fixation method, implant selection, imaging, anesthesia, hospital stay and postoperative rehabilitation.
| Procedure | Approximate Cost Range |
|---|---|
| Reducible fractures, percutaneous | ₹50,000 ₹1,20,000 |
The above figures are approximate estimates and the final cost may vary depending on the type and complexity of the fracture and the fixation method required. The total expense may include consultation, X-rays or other imaging, surgeon and anesthesia charges, operation theatre expenses, implants or fixation devices, hospital stay, medicines and follow-up care. More complex fractures or cases requiring open surgery may have higher treatment costs.
Factors Affecting the Cost of CRIF
The cost of CRIF depends on the location and complexity of the fracture, its reducibility, the type of fixation required and the implants used. Diagnostic imaging, anesthesia, hospitalization, associated injuries and postoperative rehabilitation can also influence the overall treatment expense.
- →
Fracture location: Different bones may require different fixation techniques and implant systems.
- →
Fracture pattern: The number of fragments, displacement and stability can affect surgical complexity.
- →
Reducibility: CRIF is suitable only when the fracture can be adequately aligned through closed techniques.
- →
Fixation method: Wires, pins, screws, nails or other fixation devices may be selected depending on the fracture.
- →
Implant selection: The type, number and specifications of implants can influence the overall cost.
- →
Imaging requirements: X-rays and, when required, CT scans may be used for fracture assessment and surgical planning.
- →
Anesthesia: Anesthesia or sedation requirements can add to the procedure cost.
- →
Surgical complexity: Difficult fracture patterns may require additional operative time or conversion to an open procedure.
- →
Associated injuries: Additional fractures or soft-tissue injuries can increase treatment and hospitalization costs.
- →
Hospital stay: The duration of admission and postoperative monitoring can affect the final bill.
- →
Rehabilitation: Physiotherapy and follow-up imaging may contribute to the overall treatment expense.
- →
Implant removal: If fixation implants need to be removed later, this is generally considered a separate procedure and may involve additional charges.
Insurance Coverage for CRIF
CRIF for a medically necessary fracture may be covered by health insurance, subject to the terms and conditions of the individual policy. Coverage can vary based on implant limits, hospitalization benefits, exclusions, waiting periods and pre-authorization requirements. Patients should confirm their coverage and implant-related benefits with their insurance provider before treatment.
- Checking your policy coverage
- Cashless approval process
- Required documentation
- Insurance-related queries before the procedure
Dr. Sai Kishan
Orthopaedic & Joint Replacement Surgeon
Dr. Sai Kishan Sirasala is a Consultant Orthopaedic Surgeon at Lux Hospitals, Hyderabad, with expertise in orthopedic surgical care, arthroscopy, sports medicine and joint replacement. Patients with fractures can consult him for detailed evaluation and treatment planning, including assessment of whether CRIF or another fracture fixation method is appropriate. During the consultation, the doctor may assess: Location and type of fracture Degree of displacement and fracture stability Whether the fracture can be reduced through a closed approach X-ray or CT findings when required Bone and soft-tissue condition Appropriate fixation technique and implant selection Need for open reduction if closed reduction is not adequate Associated injuries or additional fractures Expected healing period and weight-bearing restrictions Postoperative rehabilitation and follow-up requirements The recommended treatment is determined based on the fracture pattern, stability, reducibility, patient's overall health and expected functional recovery.
Consultation with Dr. Sai Kishan Sirasala Consultation with Dr. Sai Kishan SirasalaCommon Questions
Frequently Asked Questions
Not sure which treatment is right for you?
Book a consultation with Dr. Sai Kishan and get a personalised treatment plan.