Which of the following is the first priority when managing long bone fracture?

Explanation

Core Concept: Long bone fractures (e.g., femur, pelvis) can result in significant occult blood loss (up to 1-2 liters per femur fracture). The immediate priority in trauma management is to minimize this bleeding to prevent hypovolemic shock.

Clinical Presentation:

• Pain, swelling, deformity, and crepitus at the fracture site.
• Signs of hypovolemic shock if blood loss is severe.

Diagnosis:

• First-line tool: Clinical examination and ATLS primary/secondary survey.
• Gold standard: X-rays of the affected limbs and pelvis.

Management:

• Acute: Immediate splinting and immobilization of the fractured limb. This decreases soft tissue trauma, reduces pain, and tamponades bleeding by aligning the bone ends.
• Long-term/Definitive: Definitive orthopedic fixation (e.g., intramedullary nailing, external fixation) once the patient is hemodynamically stable.