Missed diagnosis of fracture in patients with traumatic brain injury: an analysis of 52 cases / 中华神经医学杂志

ABSTRACT

Objective To explore the causes and preventive measures of missed diagnosis of motor system's fiactures following traumatic brain injury.Methods Retrospective analysis was performed on 52 patients suffering from severe traumatic brain injury and motor system's fractures from January 1995 to December 2009. Statistical analysis was performed to demonstrate the relation between doctors' seniority and the missed diagnosis on fracture, and different results between the patients with missed diagnosis and correct diagnosis were compared. Results 56 fractures, including fractures spinal in 18, pelvic fractures in 11 and fractures of the extremities in 23, were noted in 52 patients. The doctors' seniority was closely correlated to the missed diagnosis rate; the residents had a significantly higher missed diagnosis rate than the attending physicians (P＜0.05). Patients with fractures of the extremities showed obviously low efficacy than those with correct diagnosis (P＜0.05). Conclusion strict and regulated medical examinations and timely X-ray photographs or CT examination can help to make correct diagnosis; choosing the proper operation time on the fractures can effectively reduce the morbidity rate.