2020
DOI: 10.1136/bmjoq-2018-000550
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Missed posterior shoulder fracture dislocations: a new protocol from a London major trauma centre

Abstract: BackgroundA high incidence of missed posterior shoulder dislocations is widely recognised in the literature. Concern was raised by the upper limb multidisciplinary team at a London major trauma centre that these missed injuries were causing serious consequences due to the need for surgical intervention and poor functional outcome.ObjectiveTo identify factors contributing to missed diagnosis and propose solutions.MethodsA local quality improvement report was performed investigating time from admission to diagno… Show more

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Cited by 6 publications
(3 citation statements)
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“…Some scholars have reported using the modified axillary view 12 and the Velpeau view 6 in acute shoulder trauma because they do not require any patient arm movement while improving the sensitivity of the post‐reduction series. However, these views require patients to stand and lean forward 12 and backwards 6 enough to achieve a superior to inferior view of the shoulder, which might not be possible when the patient is unable to move or is sedated. The MTA view does not require any patient rotation or tilt, which is feasible for all patient conditions, especially in ED.…”
Section: Discussionmentioning
confidence: 99%
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“…Some scholars have reported using the modified axillary view 12 and the Velpeau view 6 in acute shoulder trauma because they do not require any patient arm movement while improving the sensitivity of the post‐reduction series. However, these views require patients to stand and lean forward 12 and backwards 6 enough to achieve a superior to inferior view of the shoulder, which might not be possible when the patient is unable to move or is sedated. The MTA view does not require any patient rotation or tilt, which is feasible for all patient conditions, especially in ED.…”
Section: Discussionmentioning
confidence: 99%
“…Axial shoulder projections are deemed most sensitive to detect bony abnormalities but require rotation or abduction of the arm 2,5 . Thus, these axial views are challenging to obtain in trauma situations, as patients tend to have limited range of movement, are experiencing considerable pain, or are sedated 2,3,6 …”
Section: Introductionmentioning
confidence: 99%
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