Orthopedic extremity trauma – sprains, strains, and fractures

Catherine A. Marco, Jason B. Lester

Research output: Chapter in Book/Report/Conference proceedingChapter


While mechanical approaches (e.g. splinting) are important in managing sprain, strain, and fracture (SSF) pain, pharmacotherapy retains an important position for orthopedic analgesia. Systemic analgesics used for SSF include acetaminophen (paracetamol), NSAIDs, and opioids. This chapter focuses on systemically active analgesics. Pain relief for SSF can often be facilitated with local or regional injection of local anesthetics. Opioids have long been effectively used for severe SSF pain. Intravenous opioids (e.g. morphine) remain the most effective means for achieving both rapid analgesia and sustained relief (e.g. using patient-controlled analgesia) in most SSF conditions when combined with acetaminophen, the mixed-mechanism opioid tramadol is found to be equally efficacious to hydrocodone for relieving SSF pain. Many combination products are available and often include an opioid and a weaker analgesic such as acetaminophen or aspirin. However, few studies have rigorously evaluated their performance against alternative approaches such as opioid monotherapy.

Original languageEnglish (US)
Title of host publicationEmergency Department Analgesia
Subtitle of host publicationAn Evidence-Based Guide
PublisherCambridge University Press
Number of pages8
ISBN (Electronic)9780511544835
ISBN (Print)9780521696012
StatePublished - Jan 1 2008

All Science Journal Classification (ASJC) codes

  • General Medicine


Dive into the research topics of 'Orthopedic extremity trauma – sprains, strains, and fractures'. Together they form a unique fingerprint.

Cite this