Delayed Presentation of Primarily Missed Fractures Reporting to a Tertiary Care Centre: a Retrospective Study

Background: The purpose of the study was to evaluate the most frequently missed fractures by primary care physicians and identify the most difficult areas of radiographic interpretation and suggest measures to avoid these in future. Materials and Method: A retrospective study was carried on hospital based data of a period of three years from 2009 to 2012 of all patients with fractures which were initially missed by primary care physicians and presented late to the hospital. Results: A total of 50 fractures where confirmed to have been missed by primary care physicians during this period from the hospital records. Out of these 34 (68%) cases where seen in children less than 14 years of age (average 7.6 years) and 16 (32%) in adults. The most frequently missed fractures where around the elbow 14 (28%), wrist and hand 12 (24%), around hip 11 (22%), ankle 8 (16%) and 5 (10%) in other regions including 2 in foot, 1 each in spine, shoulder and knee. Conclusion: This study revealed that majority of missed injuries are seen around the elbow and the hip. If missed and not treated properly can lead to serious complications. So it is suggested that all primary care physicians should undergo a specifically directed educational program in these areas to suspect and diagnose such injuries in time to avoid any complications related to such injuries.