Missed foot fractures in polytrauma patients: a retrospective cohort study

نویسندگان

  • Annette B Ahrberg
  • Benjamin Leimcke
  • Andreas H Tiemann
  • Christoph Josten
  • Johannes KM Fakler
چکیده

BACKGROUND Missed foot fractures are a known problem in the care of the traumatized patient. They do not usually have an influence on the survival, but on the long-term result and the quality of the patient's life. The aim of this study is to find out how many of these fractures are overlooked in a Level I trauma center and what the consequences for the patients are hypothesing that patients with a delayed diagnosis will have worse clinical results. METHODS Forty-seven patients (7.3%) with foot fractures could be identified in 642 polytrauma patients, retrospectively. All patients were divided into two groups: early diagnosed fractures and delayed diagnosed fractures, the latter defined as diagnosed after Secondary Survey. Patients were evaluated according to the Hannover Outcome Score, the Short Form-36 Health Survey, the AOFAS Score and the Hannover Scoring System. The average follow-up was 5 years and 8 months. Reasons for overlooking a foot fracture were analyzed. RESULTS The foot fracture was early diagnosed in 26 (55.3%) patients, but delayed in 21 (44.7%). There were no significant differences in the mean stay in the hospital or in the ICU. The fractures that were most often missed were those of the cuboid or the metarsalia. The highest risk factor for a delayed diagnosis was a fracture already diagnosed on the same foot. In 52.4% of the delayed diagosed fractures, an operative therapy was necessary. There were no significant differences between the two groups in the clinical results. CONCLUSIONS In summary, the results of this study show that foot injuries can be a safety problem for the patient and the examination of the feet in the trauma room has to be a compulsory part of the algorithm. Although the majority of delayed diagnosed foot fractures demonstrated comparable results to the immediately diagnosed fractures, approximately 10% might have benefited from an earlier diagnosis. Even if there were no significant differences in the clinical results, we have to be aware that missing a fracture in the foot can lead to worse results in the complete polytrauma care.

برای دانلود رایگان متن کامل این مقاله و بیش از 32 میلیون مقاله دیگر ابتدا ثبت نام کنید

ثبت نام

اگر عضو سایت هستید لطفا وارد حساب کاربری خود شوید

منابع مشابه

Distribution and treatment of clavicular fractures in monotrauma and polytrauma patients

BACKGROUND Although extensive research for the optimal treatment of clavicle fractures has been performed, comparative studies between monotrauma and polytrauma patients are lacking. OBJECTIVE To compare fracture distribution and treatment in monotrauma and polytrauma patients with a clavicle fracture. METHODS Single center retrospective cohort study. Fractures were classified by the Robins...

متن کامل

Epidemiological Pattern of Foot Injuries in India: Preliminary Assessment of Data from a Tertiary Hospital

Foot injuries are an often disabling, especially when the diagnosis is delayed and treatment is inappropriate; this becomes significant in polytrauma where diagnosis maybe missed, and in young adults who are injured in the prime of life. No data on foot injury is available from India or any other developing country; we undertook a prospective 1 year study to evaluate incidence and epidemiology ...

متن کامل

Isolated radial head dislocation, a rare and easily missed injury in the presence of major distracting injuries: a case report

High velocity accidents can lead to major injuries - long bone fractures, abdominal trauma, pelvic fractures and chest injuries. These injuries can act as distracting factors during the initial assessment of a polytrauma patient and innocuous but significant smaller injuries can be missed. We present a rare case of isolated anterolateral radial head dislocation in a polytrauma patient.

متن کامل

Biochemical Correlations in Polytrauma Patients with Unstable Pelvic Fractures

14 Olivera Lupescu 8 Calea Floreasca, 1 District, 014461, Bucharest, Romania e-mail: [email protected] Abstract. Polytrauma represents an association of multiple injuries capable of inducing a systemic response and resulting in a life-threatening condition. Regardless of the different approaches and definitions, the severity of this association, determined by a specific pathophysiology,...

متن کامل

Designing a Prognostic Scoring System for Predicting the Outcomes of Proximal Fifth Metatarsal Fractures at 20 Weeks

Background: Fractures of the proximal fifth metatarsal bone are among the most common fractures observed in the foot and their classification and management has been subject to much discussion and disagreement. In this study, we aim to identify and quantify the effect of possible predictors of the outcome of the treatment of proximal fifth metatarsal fractures.Methods: Patients with established...

متن کامل

ذخیره در منابع من


  با ذخیره ی این منبع در منابع من، دسترسی به آن را برای استفاده های بعدی آسان تر کنید

عنوان ژورنال:

دوره 8  شماره 

صفحات  -

تاریخ انتشار 2014