Diagnosing isolated nasal fractures in the emergency department: are they missed or overdiagnosed? Ten years experience of 535 forensic cases

Şener, Mustafa Talip; Kök, Ahmet Nezih; Kara, Cankat; Ançi, Yüksel; Sahingoz, Sadik; Emet, Mücahit

doi:10.1007/s00068-014-0373-z

Eur J Trauma Emerg Surg

2014

DOI: 10.1007/s00068-014-0373-z

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Diagnosing isolated nasal fractures in the emergency department: are they missed or overdiagnosed? Ten years experience of 535 forensic cases

Mustafa Talip Şener

Ahmet Nezih Kök

Cankat Kara

et al.

Abstract: We found that nasal fractures are rarely missed while the overdiagnosis was very common. Examination of patients by a general practitioner or an emergency physician without consultation with a specialist and using only plain radiographs were found to be independent parameters affecting overdiagnosis.

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Cited by 3 publications

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“…[4] Indeed, the correlation between radiological findings and the presence of a clinical deformity and a fracture is low. [5,6] On the other hand, a radiological examination may be required for medicolegal purpose or to justify a sick-leave. Indeed, an X-ray confirmation of the bone fracture may be required for reasons such as: for health insurance and private insurance companies, to request a corrective rhinoplasty, in cases of total incapacity for work (in criminal court: certificates of violence and injury requested by the victims in case of physical assault) or total temporary disability (for a civil court claim for compensation).…”

mentioning

confidence: 99%

Diagnostic errors of nasal fractures in the emergency department: A monocentric retrospective study

Rebours¹,

Glatre²,

Plaisance³

et al. 2022

World Journal of Emergency Medicine

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mentioning

confidence: 99%

Diagnostic errors of nasal fractures in the emergency department: A monocentric retrospective study

Rebours¹,

Glatre²,

Plaisance³

et al. 2022

World Journal of Emergency Medicine

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Etiology of Nasal Bone Fractures

Hwang

2017

Journal of Craniofacial Surgery

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The aim of this study was to perform a systematic review of the etiology of nasal bone fractures (NBFs).In PubMed (500 titles) and Scopus (272), the search terms "nasal bone fracture" AND "etiology OR cause" were used. Among the 772 titles, 137 were duplicated and excluded. The 552 titles were excluded and 83 abstracts were read. Subsequently, 42 abstracts were excluded and 41 full articles providing data on etiologies of NBFs were reviewed. Finally, 26 papers were incorporated into this analysis.The causes of NBFs were different between adults and children. In adults, the most frequent causes were fights (36.3%), traffic accidents (20.8%), sports (15.3%), and falls (13.4%). In children, the most frequent causes were sports (59.3%), fights (10.8%), traffic accidents (8.3%), collisions (5.0%), and falls (3.3%). It is noticeable that fights, traffic accidents, and falls were more frequent in adults than in children, although sports and collisions were more frequent in children than in adults (P < 0.001). The causes of NBFs varied geographically. Fights were the most frequent cause in Asia (36.7%), South America (46.5%), and Europe (40.8%). In North America, however, traffic accidents were the most frequent cause (33.6%), followed by fights (20.7%) and sports (17.3%). Among the sports injuries, ball-related sports were the most frequent cause (84.2%). Fighting-related sports (6.4%) contributed to relatively small proportion of NBFs.In efforts to prevent NBFs in children, sports injuries should be primarily considered. Restraining devices such as seatbelts are needed to prevent NBFs caused by traffic accidents, especially in North America.

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Characterizing and quantifying low-value diagnostic imaging internationally: a scoping review

et al. 2022

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Background Inappropriate and wasteful use of health care resources is a common problem, constituting 10–34% of health services spending in the western world. Even though diagnostic imaging is vital for identifying correct diagnoses and administrating the right treatment, low-value imaging—in which the diagnostic test confers little to no clinical benefit—is common and contributes to inappropriate and wasteful use of health care resources. There is a lack of knowledge on the types and extent of low-value imaging. Accordingly, the objective of this study was to identify, characterize, and quantify the extent of low-value diagnostic imaging examinations for adults and children. Methods A scoping review of the published literature was performed. Medline-Ovid, Embase-Ovid, Scopus, and Cochrane Library were searched for studies published from 2010 to September 2020. The search strategy was built from medical subject headings (Mesh) for Diagnostic imaging/Radiology OR Health service misuse/Medical overuse OR Procedures and Techniques Utilization/Facilities and Services Utilization. Articles in English, German, Dutch, Swedish, Danish, or Norwegian were included. Results A total of 39,986 records were identified and, of these, 370 studies were included in the final synthesis. Eighty-four low-value imaging examinations were identified. Imaging of atraumatic pain, routine imaging in minor head injury, trauma, thrombosis, urolithiasis, after thoracic interventions, fracture follow-up and cancer staging/follow-up were the most frequently identified low-value imaging examinations. The proportion of low-value imaging varied between 2 and 100% inappropriate or unnecessary examinations. Conclusions A comprehensive list of identified low-value radiological examinations for both adults and children are presented. Future research should focus on reasons for low-value imaging utilization and interventions to reduce the use of low-value imaging internationally. Systematic review registration: PROSPERO: CRD42020208072.

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Diagnosing isolated nasal fractures in the emergency department: are they missed or overdiagnosed? Ten years experience of 535 forensic cases

Cited by 3 publications

References 12 publications

Diagnostic errors of nasal fractures in the emergency department: A monocentric retrospective study

Diagnostic errors of nasal fractures in the emergency department: A monocentric retrospective study

Etiology of Nasal Bone Fractures

Characterizing and quantifying low-value diagnostic imaging internationally: a scoping review

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