Prevalence of Missed Orthopedic Injuries among Patients with Multiple Trauma

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. 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. 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. Tertiary surveys in multiple trauma patients could be of great benefit in identifying missed injuries and eventually cause better patient management.