Long Bone Fracture

A long bone fracture is a break in one of the body’s long bones, such as the femur, tibia, humerus, or forearm bones, usually resulting from trauma such as falls, road traffic accidents, or direct blows.

• Pain and swelling at the injury site
• Visible deformity, shortening, or abnormal angulation of the limb
• Inability to bear weight or use the affected limb normally
• Bruising over the area
• In open fractures, a wound with visible bone or bleeding at the fracture site

• Falls, especially from height.
• Road traffic accidents.
• Direct blows or crush injuries.
• Underlying bone weakness (such as from osteoporosis or, less commonly, other bone conditions) can result in fractures from relatively minor trauma.

• Diagnosed clinically based on the mechanism of injury, pain, deformity, and inability to use the limb.
• X-ray of the affected area confirms the fracture, its type, and displacement, and guides treatment planning.
• Assessment for associated injuries — such as nerve or blood vessel damage, or injury to nearby joints — is an essential part of the examination.

Initial management includes pain relief, immobilising the limb with a splint to prevent further injury and reduce pain, and checking circulation and sensation in the limb below the fracture.

Open fractures are covered with a clean dressing, given antibiotics to reduce infection risk, and require urgent surgical assessment.

Closed fractures that are well-aligned may be treated with a cast or splint alone, while displaced or unstable fractures often require surgical fixation, depending on the bone involved and the degree of displacement.

Tetanus immunisation status is checked and updated where needed, especially for open fractures.

Rehabilitation with physiotherapy after the bone has healed helps restore strength and range of motion.

• Use appropriate safety measures to prevent falls, particularly for young children and older adults.
• Follow road safety practices, including seatbelt and helmet use.
• Ensure safe workplace practices to reduce occupational injury.
• Maintain bone health through adequate nutrition and physical activity, particularly in older adults at risk of fragility fractures.