Prevalence of Missed Orthopedic Injuries among Patients with Multiple Trauma

Abstract

Background and purpose: Missed detection of some major trauma in the context of multiple trauma remains a persistent problem in both clinical aspects and forensic medicine. This study aimed at investigating the prevalence of missed injuries in patients with major trauma. Materials and methods: This prospective cross-sectional study was done in all multiple trauma patients (7-28 years of age) admitted to emergency, orthopedic, and surgical departments in Sari Imam Khomeini Hospital, 2016. Data was collected using a checklist to study the demographic information (age and gender), mechanism of injury, time of injury, the type of trauma, and treatment interventions. SPSS V19 was used for data analysis. Results: The patients were 82% males. The frequency of missed injury was 5.8%, including clavicles, metacarpal, scaphoid, acetabulum, femoral neck, intertrochanteric, heels, Lisfranc, and ankle fractures, and hip dislocation. The results indicated a relationship between the frequency of missed injuries and older ages, more trauma, male patients, blunt trauma, and higher level of consciousness (P= 0.034). Also, in 44.4% of the cases, identifying the damage led to changing the non-surgical treatment to surgical treatment. Conclusion: Tertiary surveys in multiple trauma patients could be of great benefit in identifying missed injuries and eventually cause better patient management.

Keywords

• missed injury
• trauma
• musculoskeletal injuries
• primary survey
• secondary survey