Long bone fracture

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.

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.

A fracture is an abnormal disruption in the continuity of a bone and is often referred to as a broken bone.

For the purposes of this topic, long bones are defined as the humerus, radius, ulna, femur, tibia, and fibula. This topic focuses on extra-articular fractures (i.e., fractures that do not extend into a joint).