• This monograph covers long bone fractures and includes fractures of the humerus, radius, ulna, femur, tibia, and fibula.
  • Acute fractures usually have a dramatic presentation, whereas stress fractures often present more subtly.
  • 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.
  • Proper immobilization, analgesia, and timely orthopedic referral as appropriate can greatly enhance patient comfort and ensure optimal outcome. Some nondisplaced long bone fractures can be treated conservatively, but consultation with an orthopedist is generally recommended.
  • Potential life-threatening complications include acute compartment syndrome, fat embolism, and hemorrhage.

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