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Highlights & Basics
- Long bone fractures usually manifest with pain, swelling, and impaired function of the extremity. Deformity indicates a displaced fracture.
- Acute fractures usually have a dramatic presentation, whereas fatigue fractures (a subtype of stress fracture) often present more subtly. Pathologic and insufficiency fractures usually cause a sudden or insidious onset of pain.
- Acute fractures in older people often occur with relatively low-energy trauma, whereas in younger patients with previously healthy bone, they usually result from higher-energy trauma.
- Associated injuries should be diligently searched for and neurovascular status should be evaluated.
- At least two 90° orthogonal x-rays (e.g., anteroposterior and lateral) should be obtained, with inclusion of the joints proximal and distal to the site of suspected injury.
Quick Reference
History & Exam
Key Factors
Other Factors
Diagnostics Tests
Treatment Options
Definition
Epidemiology
Etiology
Pathophysiology
Images
OTA classification of radius and ulna fractures - locations, types, and groups
Bilateral insufficiency lesions in proximal femora in a 63-year-old woman taking weekly alendronate
X-ray showing osteoporotic ulnar fracture involving the proximal third of the shaft with associated dislocation of the radial head at the elbow (Monteggia fracture)
X-ray showing midshaft femur fracture
X-ray showing a segmental fracture of the tibia and fibula
Recommended immobilization techniques for long bone fractures
Sugar-tong splint
Double sugar-tong splint
Posterior leg splint
BMJ Rapid Recommendations: low-intensity pulsed ultrasound (LIPUS) for bone healing
Citations
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National Institute for Health and Care Excellence. Fractures (complex): assessment and management. Nov 2022 [internet publication].[Full Text]
American Academy of Orthopaedic Surgeons. Prevention of surgical site infections after major extremity trauma. Evidence-based clinical practice guideline. Mar 2022 [internet publication].[Full Text]
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