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Open Reduction and Internal Fixation (ORIF) of the patella is a surgical procedure to treat a fractured patella (knee cap). Open reduction refers to open surgery to set bones, and is necessary for some fractures. Internal fixation refers to the fixation of screws and /or plates to enable or facilitate healing. The patella (knee cap) is a sesamoid bone that is embedded in the quadriceps tendon at the front of the knee. Fractures to the patella can occur when the force applied to the patella is stronger than the bone either by a direct blow to the knee cap or as a result of indirect forces from a powerful contraction of the quadriceps. A fracture to the patella can either be displaced (out of position) or undisplaced (in position). If the fracture is undisplaced or minimally displaced then surgery may not be required. If a fracture to the patella is significantly displaced then ORIF surgery will be necessary. During ORIF surgery, an incision is made over the front of the knee joint. The fractured ends are then realigned (open reduction) and held in place with a combination of pins, screws, and wires (internal fixation). It is important to undergo ORIF immediately after suffering a displaced fracture of the patella as this will reduce pain, aid the healing process and prevent any further problems or injuries in the future.