Occassionally we meet patients who have received inadequate treatment. In our hospital, patients are first examined 1st year or 2nd year trainees, therefore we investigated the features of missed fractures and how to diminish the number of these and how to salvage the patients.
From January 1993 to July 1994, 8, 490 patients with trauma came to the emergency center in our hospital. Among these patients, 169 people were questioned as possible missed fractures or inadequate treatment and were re-evaluated.
The following results were found:
1. Elbow fractures were missed frequently.
2. The features of missed fractures were minimal displacement, small fragments, unclear fracture lines.
3. Inexperience of examination and ability of reading films.
4. Orthopaedic specialists and radiologists read the films; staff call the patients who were doubtful about missing fracture.
5. It is necessary to have feedback for trainees.
