Look For Missed Extremity Fractures in Patients with a Diagnosed Extremity Fracture



Look For Missed Extremity Fractures in Patients with a Diagnosed Extremity Fracture


William S. Hoff MD



Missed injuries, commonly referred to as “the trauma surgeon’s nemesis,” are an expected occurrence in the management of multiply injured patients. The definition of a missed injury is institution specific. Generally speaking, however, a missed injury is an injury identified at some defined time after the initial assessment. Missed injuries are not frequently life-threatening. However, depending on the exact circumstances, a missed injury may result in long-term disability. Moreover, missed injuries may complicate the relationship between the health care provider and his or her patient.

The initial assessment of a trauma patient consists of a primary and a secondary survey. The purpose of the primary survey is to simultaneously identify and initiate treatment of immediately life-threatening conditions. The secondary survey consists of a systematic, head-to-toe physical examination. A definitive care plan is established based on injuries identified in the initial assessment. Despite a carefully performed initial assessment, the incidence of missed injury is approximately 10%. The majority of missed injuries are musculoskeletal injuries, a large proportion of which are extremity injuries. The following conditions are associated with missed injuries in trauma patients:

Jul 1, 2016 | Posted by in ANESTHESIA | Comments Off on Look For Missed Extremity Fractures in Patients with a Diagnosed Extremity Fracture
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