Abstract :
Missed injuries is defined as an injury found after the initial complete patient assessment and diagnostic studies that was directly related to the traumatic event and was identified after first 24 hours following admission. Even though not frequently life-threatening, they may result in significant long-term disability. The aim of this study was to define the incidence of missed orthopaedic injury for adult major trauma patients and to examine the details of missed injuries in order to identify and make comment on potential risk factors for missed injury. 671 admissions in orthopaedics indoor patients in a rural tertiary care centre for the period of 10 months from 1st January 2016 to 31st October 2016 were included for study. 18 patients were identified with delayed diagnoses of the injury. Patients with a decreased level of consciousness or head injury, with intubation/sedation or with alcohol or drug intoxication are unable to give a good history, cooperate with physical exam or identify sources of pain are the main risk factors for missed injuries. Other factors for missing an injury include Inadequate Clinical Assessment, Misinterpretation of Studies and Late Presentation of Observable Findings. Repeated assessments, both clinical and radiological, are mandatory to diminish this problem. In initial evaluation, one still has to treat the greatest threat to life before complete diagnosis of all injuries, but alertness to evolving injuries must remain in mind throughout the patient’s hospital stay.
Keyword :
Missed Injury, Orthopaedics, Adults