Background: Musculoskeletal trauma represents a considerable global health burden. Lower limb long bone fractures are seen as a serious concern at the individual and population level. So the purpose of the study was to find incidence and cause of delay for treatment of long bone fractures of the lower limb in tertiary care hospital.Methods: All adult patients (more than 18 years) reporting to Emergency Medicine Department of a tertiary care hospital with long bone fractures of lower limb were included in the study. Effects on the final outcome on the lifestyle of the patients were evaluated against the interventions and management at all stages of the course of the illness. Delay of surgery: in our study delay of surgery means if surgery occurs after one day (24 hours) of admission. The entire data is statistically analysed using SPSS software. P values less than 0.05 are considered to be statistically significant.Results: 74 operated cases. 60 cases (81.10%) had delayed surgery, 14 cases (18.9.0%) did not have delayed surgery. 33 cases (55%) had medical reason for delay, 19 cases (31.7%) had financial reason for delay, 5 cases (14.3%) had infrastructure issues (unit system/non availability of implant), 3 cases (5.0%) had plan of surgery as causes of delay.Conclusions: These factors have an effect in the final outcome of the cases. The final outcome is dependent on multiple factors. Adequate attention to each and every one of them was long way to get the patient to the pre-incident stage.

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Background: Musculoskeletal trauma represents a considerable global health burden. Pain is a complex, subjective personal experience. The assessment of pain is the essential perquisite for successful pain management. It is useful to decide the plan of initial treatment but also to reassess the degree of success. So the purpose of the study was to do assessment of pain management intervention, post-op analgesics for treatment of long bone fractures.Methods: All adult patients (more than IS years) reporting to Emergency Medicine Department of a tertiary care hospital with long hone fractures of lower limb were included in the study. Patient pain management was assessed by visual analogue score (VAS). Pain is a complex, subjective personal experience. The assessment of pain is the essential perquisite for successful pain management. It is useful to decide the plan of initial treatment but also to reassess the degree of success. The entire data is statistically analyzed using SPSS software. p-values less than 0.05 are considered to be statistically significant.Results:  74 cases got operated, 64 cases (86.5.0%) did not have any intra-op complications and 10 cases (13.50%) had intra-op complications .Postoperative analgesia the 74 cases operated was as follows: 17 cases (23.0%) epidural anaesthesia 41 Cases (55.4%) had epidural + intravenous analgesics. Recent was managed with 1.V, analgesics alone; 12 cases (16.20%) had tramadol, 2 cases (2.7%) received paracetamol and 2 cases (2.7%) had dynaper for post-operative analgesia.Conclusion: Adequate pain management on arrival in the Emergency Department is an important aspect in patient care and is not at all difficult to achieve. Femoral nerve block in Proximal lower limb fractures is very effective and easy to perform.

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