Overview
This guideline covers assessing and managing non-complex fractures that can be treated in the emergency department or orthopaedic clinic. It aims to improve practice so that people with fractures receive the care that they need without unnecessary tests and treatments.
The guideline should be read alongside the NICE guidelines on major trauma, major trauma: service delivery, spinal injury and fractures (complex).
Last reviewed: 23 June 2025
We removed the recommendation for research on post-operative weight-bearing in people with ankle fractures because there is now a definitive trial, so the evidence gap no longer exists. See the surveillance decision for further details.
Next review: This guideline will be reviewed if there is new evidence that is likely to change the recommendations.
How we prioritise updating our guidance
Decisions about updating our guidance are made by NICE’s prioritisation board. For more information on the principles and process see NICE-wide topic prioritisation: the manual.
For information about individual topics, including any decisions affecting this guideline, see the summary table of prioritisation board decisions.
Recommendations
This guideline addresses variation in practice and includes recommendations on:
- initial pain management and immobilisation
- acute stage assessment and diagnostic imaging
- management in the emergency department
- ongoing orthopaedic management
- documentation, and information and support for patients, family members and carers
- non-accidental injury
Who is it for?
- Healthcare professionals and practitioners who provide care for people with fractures
- People with fractures, their families and carers
Guideline development process
How we develop NICE guidelines
Your responsibility
The recommendations in this guideline represent the view of NICE, arrived at after careful consideration of the evidence available. When exercising their judgement, professionals and practitioners are expected to take this guideline fully into account, alongside the individual needs, preferences and values of their patients or the people using their service. It is not mandatory to apply the recommendations, and the guideline does not override the responsibility to make decisions appropriate to the circumstances of the individual, in consultation with them and their families and carers or guardian.
All problems (adverse events) related to a medicine or medical device used for treatment or in a procedure should be reported to the Medicines and Healthcare products Regulatory Agency using the Yellow Card Scheme.
Local commissioners and providers of healthcare have a responsibility to enable the guideline to be applied when individual professionals and people using services wish to use it. They should do so in the context of local and national priorities for funding and developing services, and in light of their duties to have due regard to the need to eliminate unlawful discrimination, to advance equality of opportunity and to reduce health inequalities. Nothing in this guideline should be interpreted in a way that would be inconsistent with complying with those duties.
Commissioners and providers have a responsibility to promote an environmentally sustainable health and care system and should assess and reduce the environmental impact of implementing NICE recommendations wherever possible.