165 patients with closed extremity fractures were randomized to receive either intravenous (IV) ibuprofen (n=55), intravenous ibuprofen + acetaminophen (n=55), or intravenous morphine (n=55). The primary outcome of interest was pain on a Visual Analog Scale after one hour. Secondary outcomes included VAS pain at 5, 15, and 30 minutes and the incidence of moderate to severe adverse events. At 5 minutes, the IV morphine group presented with significantly lower pain scores compared to the other two groups. At 15 minutes, the morphine group had significantly lower pain scores when compared to the IV Ibuprofen group. Similarly, the IV ibuprofen group had significantly lower pain scores compared to the combination group. At 30 minutes, the IV ibuprofen group showed significantly lower pain scores compared to the other two groups. Lastly, at one hour, the combination group had significantly lower pain scores compared to the IV ibuprofen group.