UpToDate
Official reprint from UpToDate®
www.uptodate.com ©2017 UpToDate®

General principles of acute fracture management

Authors
Richard Derby, MD
Anthony Beutler, MD
Section Editors
Patrice Eiff, MD
Chad A Asplund, MD, FACSM, MPH
Deputy Editor
Jonathan Grayzel, MD, FAAEM

INTRODUCTION

Patients with suspected fractures require urgent and sometimes emergent evaluation to determine if serious complicating conditions exist. Such conditions, including any neurovascular injury, often require immediate surgical consultation [1,2]. Nevertheless, many fractures are uncomplicated and can be managed effectively in a non-surgical setting.

The acute management of uncomplicated fractures is reviewed below and involves the following steps:

Initial clinical assessment

Radiographic assessment

Immobilization

            

Subscribers log in here

To continue reading this article, you must log in with your personal, hospital, or group practice subscription. For more information or to purchase a personal subscription, click below on the option that best describes you:
Literature review current through: May 2017. | This topic last updated: Dec 07, 2016.
The content on the UpToDate website is not intended nor recommended as a substitute for medical advice, diagnosis, or treatment. Always seek the advice of your own physician or other qualified health care professional regarding any medical questions or conditions. The use of this website is governed by the UpToDate Terms of Use ©2017 UpToDate, Inc.
References
Top
  1. Eiff PM, Hatch RL. Fracture Management for Primary Care, 3rd, WB Saunders, Philadelphia 2011.
  2. DeLee JC, Drez D Jr. DeLee & Drez's Orthopaedic Sports Medicine: Principles and Practice, 3rd, WB Saunders, Philadelphia 2010.
  3. Sprague S, Madden K, Dosanjh S, et al. Intimate partner violence and musculoskeletal injury: bridging the knowledge gap in orthopaedic fracture clinics. BMC Musculoskelet Disord 2013; 14:23.
  4. Wu V, Huff H, Bhandari M. Pattern of physical injury associated with intimate partner violence in women presenting to the emergency department: a systematic review and meta-analysis. Trauma Violence Abuse 2010; 11:71.
  5. PRAISE Investigators, Sprague S, Bhandari M, et al. Prevalence of abuse and intimate partner violence surgical evaluation (PRAISE) in orthopaedic fracture clinics: a multinational prevalence study. Lancet 2013; 382:866.
  6. Benjamin, HJ, Hang, BT. Common acute upper extremity injuries in sports. Clin Ped Emerg Med 2007; 8:15.
  7. Malanga GA, Ramirez-Del Toro JA. Common injuries of the foot and ankle in the child and adolescent athlete. Phys Med Rehabil Clin N Am 2008; 19:347.
  8. Ahn JM, El-Khoury GY. Occult fractures of extremities. Radiol Clin North Am 2007; 45:561.
  9. Joshi N, Lira A, Mehta N, et al. Diagnostic accuracy of history, physical examination, and bedside ultrasound for diagnosis of extremity fractures in the emergency department: a systematic review. Acad Emerg Med 2013; 20:1.
  10. Chan SS. Emergency bedside ultrasound for the diagnosis of rib fractures. Am J Emerg Med 2009; 27:617.
  11. Douma-den Hamer D, Blanker MH, Edens MA, et al. Ultrasound for Distal Forearm Fracture: A Systematic Review and Diagnostic Meta-Analysis. PLoS One 2016; 11:e0155659.
  12. Tuzun HY, Turkkan S, Arsenishvili A. The effectiveness of bedside point-of-care ultrasonography in the diagnosis and management of metacarpal fractures: Contribution for management of metacarpal fractures. Am J Emerg Med 2016; 34:674.
  13. Aksay E, Kilic TY, Yesılaras M, et al. Accuracy of bedside ultrasonography for the diagnosis of finger fractures. Am J Emerg Med 2016; 34:809.
  14. Newton EJ, Love J. Acute complications of extremity trauma. Emerg Med Clin North Am 2007; 25:751.
  15. Mazzola TJ. Splint and casting. In: The Sports Medicine Resouce Manual, Seidenberg PS, Beutler AI (Eds), WB Saunders, Philadelphia 2007. p.152.
  16. Black KJ, Bevan CA, Murphy NG, Howard JJ. Nerve blocks for initial pain management of femoral fractures in children. Cochrane Database Syst Rev 2013; :CD009587.
  17. Choi JJ, Lin E, Gadsden J. Regional anesthesia for trauma outside the operating theatre. Curr Opin Anaesthesiol 2013; 26:495.