Causes of delayed diagnosis of scapular fractures

被引:24
作者
Tadros, Ayman M. A. [1 ]
Lunsjo, Karl [2 ]
Czechowski, Jaunsz [3 ]
Abu-Zidan, Fikri M. [2 ]
机构
[1] Al Ain Hosp, Dept Orthopaed, Al Ain, U Arab Emirates
[2] UAE Univ Al Ain, Fac Med & Hlth Sci, Dept Surg, Al Ain, U Arab Emirates
[3] Al Ain Hosp, Dept Radiol, Al Ain, U Arab Emirates
来源
INJURY-INTERNATIONAL JOURNAL OF THE CARE OF THE INJURED | 2008年 / 39卷 / 03期
关键词
scapular fracture; associated injuries; missed diagnosis;
D O I
10.1016/j.injury.2007.10.014
中图分类号
R4 [临床医学];
学科分类号
1002 ; 100602 ;
摘要
Objectives: To study the causes of delayed diagnosis of scapular fractures in blunt trauma cases, and to advise on early fracture detection. Patients and methods: Between February 2003 and September 2004, 64 consecutive patients (3 females) with a median (range) age of 35 (8-60) years, treated at Al-Ain Hospital for scapular fractures, were prospectively collected. Fractures diagnosed after more than 24 h from admission were considered missed; 8 people with missed scapular fractures were compared with a control group of 56 who had timely diagnosis, regarding the mechanism and distribution of injury, injury severity score, and type and quality of radiological methods used. Results: The median (range) abbreviated injury scale scores for the missed scapular fracture group and the control group were 4 (0-5) and 2 (0-2), respectively. The missed scapular fracture group stayed significantly longer in the intensive care unit compared with the control group, with a median (range) stay of 15 (5-37) days compared with 9 (1-26) days. Associated injuries overshadowed the scapula on chest trauma radiographs. If computed tomography did not cover the whole scapula, some fractures might not be shown. Convulsive seizures were the only significantly different mechanism of injury between the missed fracture and the control groups. Conclusion: Delayed diagnosis of scapular fractures can be due to extensive chest injuries overshadowing the scapula on the chest trauma radiographs, inappropriately performed computer tomography or an unusual mechanism of injury. (c) 2007 Elsevier Ltd. All rights reserved.
引用
收藏
页码:314 / 318
页数:5
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