Most frequently overlooked radiographically apparent fractures in a teaching hospital emergency department

Freed, Howard A.; Shields, Naomi N.

doi:10.1016/s0196-0644(84)80666-6

Cited by 63 publications

(35 citation statements)

References 3 publications

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“…This result was consistent with those of previous studies. [2,5,14] The wrist and hand (n=12, 32.4%) was the second most common location of missed fracture diagnoses. There were no missed midshaft fractures of any bone.…”

Section: Discussionmentioning

confidence: 99%

See 1 more Smart Citation

The missed extremity fractures in emergency department

Er¹,

Kara²,

Oyar³

et al. 2013

Ulus Travma Acil Cerrahi Derg

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Section: Discussionmentioning

confidence: 99%

“…These results were correlated with those in the literature. [2,14] None of the fractures were considered to be clinically important after follow up. There are several limitations of our retrospective analysis.…”

Section: Discussionmentioning

confidence: 99%

The missed extremity fractures in emergency department

Er¹,

Kara²,

Oyar³

et al. 2013

Ulus Travma Acil Cerrahi Derg

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“…However, these injuries may require longer immobilization and different anticipatory guidance. 13 Because diagnostic errors in radiograph interpretation by the ED physician can result in a change in management, [28][29][30][31][32][33] we recommend a robust quality assurance system for ED physician image interpretation 34 to ensure errors are recognized and acted on.…”

Section: Figurementioning

confidence: 99%

Primary Care Physician Follow-up of Distal Radius Buckle Fractures

Koelink

Schuh²,

Howard³

et al. 2016

Pediatrics

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OBJECTIVES: Our main objective was to determine the proportion of children referred to a primary care provider (PCP) for follow-up of a distal radius buckle fracture who subsequently did not deviate from this reassessment strategy.METHODS: This prospective cohort study was conducted at a tertiary care pediatric emergency department (ED). Eligible children were aged 2 to 17 years with a distal radius buckle fracture treated with a removable splint and referred to the PCP for reassessment. We telephoned families 28 days after their ED visit. The primary outcome was the proportion who received PCP follow-up exclusively. We also measured the proportion who received PCP anticipatory guidance and those children who reported returning to usual activities "always" by 4 weeks. RESULTS:We enrolled 200 children, and 180 (90.0%) received telephone follow-up. Of these, 157 (87.2% [95% confidence interval: 82.3 to 92.1]) received PCP follow-up exclusively. Specifically, 11 (6.1%) families opted out of physician follow-up, 5 (2.8%) self-referred to an ED, and the PCP requested specialty consultation in 7 (3.9%) cases. Of the 164 with a PCP visit, 77 (47.0%) parents received anticipatory guidance on return to activities for their child, and 162 (98.8%) reported return to usual activities within 4 weeks. CONCLUSIONS:The vast majority of children with distal radius buckle fractures presented to the PCP for follow-up and did not receive additional orthopedic surgeon or ED consultations. Despite a suboptimal rate of PCP advice on return to activities, almost all parents reported full return to usual activities within 4 weeks.

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“…Despite a high rate of radiographs in elbow injury, it is one of the most important locations for missed fractures, reported as 10.8% and 6% in two different studies. [1][2][3] Clinical decision rules for obtaining radiography in different injuries such as the Ottawa ankle and knee rules, cervical spine rules and Pittsburgh knee rules have led to efficient use of radiography in injuries. [4][5][6][7][8][9][10] These rules have led to a reduced number of radiographs and eliminated unnecessary exposure to radiation in patients.…”

Section: Sonuçmentioning

confidence: 99%