TY - JOUR
T1 - Causes of delayed diagnosis of scapular fractures
AU - Tadros, Ayman M.A.
AU - Lunsjo, Karl
AU - Czechowski, Jaunsz
AU - Abu-Zidan, Fikri M.
N1 - Funding Information:
This study has been supported by a Seed Money Grant from the Faculty of Medicine and Health Sciences, United Arab Emirates University.
PY - 2008/3
Y1 - 2008/3
N2 - 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.
AB - 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.
KW - Associated injuries
KW - Missed diagnosis
KW - Scapular fracture
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U2 - 10.1016/j.injury.2007.10.014
DO - 10.1016/j.injury.2007.10.014
M3 - Article
C2 - 18243201
AN - SCOPUS:39149121826
SN - 0020-1383
VL - 39
SP - 314
EP - 318
JO - Injury
JF - Injury
IS - 3
ER -