Tarsometatarsal (Lisfranc) fracture-dislocation is an uncommon foot injury. Subtle injuries are more difficult to diagnose though they cause serious morbidity. Bilateral subtle tarsometatarsal injury has not been reported before. We report bilateral subtle tarsometatarsal dislocations that were caused by a work-related accident in a 25-year-old man. The injury was initially missed. Diagnosis wa...

BACKGROUND Missed injuries (MIs) adversely affect patient outcome and damage physician/institutional credibility. The primary and secondary surveys are designed to identify all of a patient's injuries and prioritize their management; however, MIs are prevalent in severely injured and multisystem trauma patients, especially when the patient's condition precludes completion of the secondary surve...

CONTEXT Abusive head trauma (AHT) is a dangerous form of child abuse that can be difficult to diagnose in young children. OBJECTIVES To determine how frequently AHT was previously missed by physicians in a group of abused children with head injuries and to determine factors associated with the unrecognized diagnosis. DESIGN Retrospective chart review of cases of head trauma presenting betwe...

A traumatic infra-renal aortic dissection is a rare but life-threatening injury that follows deceleration injuries. The mechanism of blunt abdominal aortic injury involves both direct and indirect forces. The successful management of patients with traumatic injuries depends on a prompt suspicion of the injury and early diagnosis and therapy. Missed injuries in trauma patients are well-described...

The goals of emergency wound treatment are to restore function, repair tissue integrity with strength and optimal cosmetic appearance, and minimize risk of infection. Risk of infection depends on the location, mechanism, host, and care. The risk for a clean facial wound produced by incision is less than 1%, whereas a dirty crush injury to the lower extremity may have more than a 20% risk. Wound...

Inversion injuries to the ankle and foot are a highly common presentation in both the emergency room and the practitioner's office. Because of its frequency the condition has been historically under diagnosed and under treated. Most often, the patient presents with a swollen, tender, and occasionally ecchymotic area after having twisted the ankle in an inversion direction. The most common injur...

Metacarpal (MCP) base fractures are less commonly encountered than diaphyseal or metacarpal neck fractures. These are difficult injuries to diagnose and are challenging to treat. Neglect of these injuries, either by missed diagnosis or by inadequate treatment, causes significant disability due a poorly functioning carpo-metacarpal joint. There have been several developments in the management of...

A basic assumption of caring for multi-injured patients is that all patients are suspected of having a cervical spine injury until proven otherwise. It is known that 2% to 4% of all blunt trauma injury patients have a cervical spine injury. Missed or delayed diagnosis of cervical spine injury occurs in 4% to 8% of patients of whom 70% have altered levels of consciousness. When these missed diag...

UNLABELLED Dislocation of the head of the radius may be either congenital, an isolated injury or more commonly part of a complex injury to the elbow such as the Monteggia fracturedislocation. Isolated traumatic radial head dislocation without associated injuries in children is a rare and easily missed condition. We report such a case in a 7-year-old boy without any associated injuries or co-mor...