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| The analysis of the missed diagnosis of the limbs and joint fracture usingradiography in the emergency department |
| ZHANG Yu-xin, WANG Shu-li |
| Tianjin Hospital, Tianjin 300211, China |
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Abstract Objective: To explore the reasons of the missed diagnosis of the limb and joint fracture using CR system in the emergency department. Methods: Thirty-six cases aged 9~68 years(mean 41.5 years) were included during the period June 2006—April 2011 which caused the dissatisfaction for the missed diagnosis of the limbs fracture in the emergency department. Results: Thirty-eight fractures were missed in the 36 cases, and the correct diagnosis was made by reviewing the radiography on the same day or after 3~11 days(mean 4.9 days). Standard position was taken in 23 cases, and non-standard position in other cases. CT was conducted in 19 cases and MR was performed in 8 cases. Conclusion: The inevitable reasons for missed diagnosis of the limbs fracture at the first examination in the emergency department include: ①Fractures caused anatomic derangement. ②Because of the body position of the patients, fracture is hidden by the bony structure.③Subtle fracture and occult fracture can’t be displayed by plain radiography. So unnecessary clinical dispute can be avoided by taking standard imagingn, fully understanding of the condition that may occur at the time of trauma, closely examine the clinical sign of the patients, close follow-up or further examination.
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Received: 26 June 2012
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2013, Vol. 24 
