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Missed foot fractures in polytrauma patients: a retrospective cohort study

BACKGROUND: Missed foot fractures are a known problem in the care of the traumatized patient. They do not usually have an influence on the survival, but on the long-term result and the quality of the patient’s life. The aim of this study is to find out how many of these fractures are overlooked in a...

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Autores principales: Ahrberg, Annette B, Leimcke, Benjamin, Tiemann, Andreas H, Josten, Christoph, Fakler, Johannes KM
Formato: Online Artículo Texto
Lenguaje:English
Publicado: BioMed Central 2014
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3944986/
https://www.ncbi.nlm.nih.gov/pubmed/24568599
http://dx.doi.org/10.1186/1754-9493-8-10
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author Ahrberg, Annette B
Leimcke, Benjamin
Tiemann, Andreas H
Josten, Christoph
Fakler, Johannes KM
author_facet Ahrberg, Annette B
Leimcke, Benjamin
Tiemann, Andreas H
Josten, Christoph
Fakler, Johannes KM
author_sort Ahrberg, Annette B
collection PubMed
description BACKGROUND: Missed foot fractures are a known problem in the care of the traumatized patient. They do not usually have an influence on the survival, but on the long-term result and the quality of the patient’s life. The aim of this study is to find out how many of these fractures are overlooked in a Level I trauma center and what the consequences for the patients are hypothesing that patients with a delayed diagnosis will have worse clinical results. METHODS: Forty-seven patients (7.3%) with foot fractures could be identified in 642 polytrauma patients, retrospectively. All patients were divided into two groups: early diagnosed fractures and delayed diagnosed fractures, the latter defined as diagnosed after Secondary Survey. Patients were evaluated according to the Hannover Outcome Score, the Short Form-36 Health Survey, the AOFAS Score and the Hannover Scoring System. The average follow-up was 5 years and 8 months. Reasons for overlooking a foot fracture were analyzed. RESULTS: The foot fracture was early diagnosed in 26 (55.3%) patients, but delayed in 21 (44.7%). There were no significant differences in the mean stay in the hospital or in the ICU. The fractures that were most often missed were those of the cuboid or the metarsalia. The highest risk factor for a delayed diagnosis was a fracture already diagnosed on the same foot. In 52.4% of the delayed diagosed fractures, an operative therapy was necessary. There were no significant differences between the two groups in the clinical results. CONCLUSIONS: In summary, the results of this study show that foot injuries can be a safety problem for the patient and the examination of the feet in the trauma room has to be a compulsory part of the algorithm. Although the majority of delayed diagnosed foot fractures demonstrated comparable results to the immediately diagnosed fractures, approximately 10% might have benefited from an earlier diagnosis. Even if there were no significant differences in the clinical results, we have to be aware that missing a fracture in the foot can lead to worse results in the complete polytrauma care.
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spelling pubmed-39449862014-03-07 Missed foot fractures in polytrauma patients: a retrospective cohort study Ahrberg, Annette B Leimcke, Benjamin Tiemann, Andreas H Josten, Christoph Fakler, Johannes KM Patient Saf Surg Research BACKGROUND: Missed foot fractures are a known problem in the care of the traumatized patient. They do not usually have an influence on the survival, but on the long-term result and the quality of the patient’s life. The aim of this study is to find out how many of these fractures are overlooked in a Level I trauma center and what the consequences for the patients are hypothesing that patients with a delayed diagnosis will have worse clinical results. METHODS: Forty-seven patients (7.3%) with foot fractures could be identified in 642 polytrauma patients, retrospectively. All patients were divided into two groups: early diagnosed fractures and delayed diagnosed fractures, the latter defined as diagnosed after Secondary Survey. Patients were evaluated according to the Hannover Outcome Score, the Short Form-36 Health Survey, the AOFAS Score and the Hannover Scoring System. The average follow-up was 5 years and 8 months. Reasons for overlooking a foot fracture were analyzed. RESULTS: The foot fracture was early diagnosed in 26 (55.3%) patients, but delayed in 21 (44.7%). There were no significant differences in the mean stay in the hospital or in the ICU. The fractures that were most often missed were those of the cuboid or the metarsalia. The highest risk factor for a delayed diagnosis was a fracture already diagnosed on the same foot. In 52.4% of the delayed diagosed fractures, an operative therapy was necessary. There were no significant differences between the two groups in the clinical results. CONCLUSIONS: In summary, the results of this study show that foot injuries can be a safety problem for the patient and the examination of the feet in the trauma room has to be a compulsory part of the algorithm. Although the majority of delayed diagnosed foot fractures demonstrated comparable results to the immediately diagnosed fractures, approximately 10% might have benefited from an earlier diagnosis. Even if there were no significant differences in the clinical results, we have to be aware that missing a fracture in the foot can lead to worse results in the complete polytrauma care. BioMed Central 2014-02-25 /pmc/articles/PMC3944986/ /pubmed/24568599 http://dx.doi.org/10.1186/1754-9493-8-10 Text en Copyright © 2014 Ahrberg et al.; licensee BioMed Central Ltd. http://creativecommons.org/licenses/by/2.0 This is an Open Access article distributed under the terms of the Creative Commons Attribution License (http://creativecommons.org/licenses/by/2.0), which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly credited. The Creative Commons Public Domain Dedication waiver (http://creativecommons.org/publicdomain/zero/1.0/) applies to the data made available in this article, unless otherwise stated.
spellingShingle Research
Ahrberg, Annette B
Leimcke, Benjamin
Tiemann, Andreas H
Josten, Christoph
Fakler, Johannes KM
Missed foot fractures in polytrauma patients: a retrospective cohort study
title Missed foot fractures in polytrauma patients: a retrospective cohort study
title_full Missed foot fractures in polytrauma patients: a retrospective cohort study
title_fullStr Missed foot fractures in polytrauma patients: a retrospective cohort study
title_full_unstemmed Missed foot fractures in polytrauma patients: a retrospective cohort study
title_short Missed foot fractures in polytrauma patients: a retrospective cohort study
title_sort missed foot fractures in polytrauma patients: a retrospective cohort study
topic Research
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3944986/
https://www.ncbi.nlm.nih.gov/pubmed/24568599
http://dx.doi.org/10.1186/1754-9493-8-10
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