Musculoskeletal Treatments: Fracture Management

Area of Science:

• Orthopedics
• Radiology
• Primary Care Medicine

Background:

• Primary care physicians are the first point of contact for patients with suspected fractures.
• Initial diagnosis relies on plain radiography or ultrasonography.
• High clinical suspicion despite negative imaging necessitates immobilization and protected weight-bearing.

Purpose of the Study:

• To outline the diagnostic and management pathway for potential fractures in primary care.
• To identify indications for orthopedic referral and surgical management.
• To highlight considerations for special populations and disparities in fracture care.

Main Methods:

• Initial evaluation using plain radiography or ultrasonography.
• Reassessment with repeat radiography or advanced imaging (CT/MRI without contrast) if suspicion remains high.
• Nonoperative management involves immobilization (brace/cast) and follow-up radiography.
• Surgical management is indicated for nonunion or malunion.

Main Results:

• Common referral indications include open, displaced, intra-articular, unstable fractures, fracture-dislocations, and neurovascular compromise.
• Nonoperative fracture management requires immobilization and repeat imaging.
• Multidisciplinary care and tailored plans improve outcomes for complex fractures and older adults.

Conclusions:

• Fracture management requires a stepwise approach involving primary care, imaging, and orthopedic referral when necessary.
• Rehabilitation protocols need further research for specific fracture types.
• Addressing racial and ethnic disparities is crucial for equitable fracture care outcomes.