Incidence and Causes of Delayed Diagnosis of Femoral Neck Fracture Ban Pong Hospital over 4 Years
Keywords:
incidence, diagnosis, radiography, fracture neck of femurAbstract
Objective: The aim was to study the incidence and causes of the delayed diagnosis of femoral neck fractures. In patients coming for treatment in the emergency or outpatient department of Ban Pong Hospital for the past 4 years.
Methods: A retrospective descriptive study was done by reviewing medical records between October 1, 2015 and September 30, 2020. The medical records were divided into part 1 ; general information . age, gender, broken side, accident history, department that provided the diagnosis, and type of surgery; part 2, types of radiographic finding to divide the fracture characteristics of the femoral neck using Garden classification. Data were analyzed by using descriptive statistics and compare the differences of the data using chi-square test.
Results: From a series of 145 consecutive admissions with a femoral neck fracture, there were 37 cases (25.3%) in which the diagnosis was not made when the patient was initially seen in hospital. When a comparative study was done between the group of patients diagnosed at first visits and the delayed diagnosis group about gender, age, fracture accident history , department that provided the diagnosis, and the type of surgery, found that there were no statistically significant differences of the two groups. The reason for the delay in diagnosis was failure to correctly interprete X-rays in 33 cases and failure to X-ray the hips in four cases. Twenty-four of the fractures (72.7%) of delayed group were initially undisplaced, but as a consequence of the delay in diagnosis, displacement were occurred.
Conclusion: The cause of delayed diagnosis in patients with femoral neck fractures is mainly associated with the interpretation of radiographic data.
References
2. Elffors L. Methodology of MEDOS multi centre study of hip fracture incidence: validity and relevance considerations. Bone. 1993; 14 Suppl 1: S45-9.
3. Dennison E. Epidemiology of osteoporosis. Rheum Dis Clin North Am. 2006; 32(4): 617-29.
4. Osnes, EK, Lofthus, CM, Meyer, HE. Consequences of hip fracture on activities of daily life and residential needs. Osteoporos Int. 2004; 15(7):567-74.
5. Becker DJ, Kilgore ML, Morrisey MA. The societal burden of osteoporosis. Curr Rheumatol Rep. 2010; 12(3): 186–91.
6. Kesmezacar H. Predictors of mortality in elderly patients with an intertrochanteric or a femoral neck fracture. J Trauma. 2010; 68(1): 153-8.
7. Giversen IM.Time trends of mortality after first hip fractures. Osteoporos Int. 2007; 18(6): 721-32.
8. Keene GS, Parker MJ, Pryor GA. Mortality and morbidity after hip fractures. BMJ. 1993; 307(6914): 1248–50.
9. Pinto A, Reginelli A, Pinto F, et al. Errors in imaging patients in the emergency setting. Br J Radiol. 2016; 89(1061).
10. Kazley JM, Banerjee S, Abousayed MM. Classifications in Brief: Garden Classification of Femoral Neck Fractures. Clin Orthop Relat Res. 2018 Feb;476(2):441-445.
11. Jain R, Koo M, Kreder HJ, et al. Comparison of early and delayed fixation of subcapital hip fractures in patients sixty years of age or less. J Bone Joint Surg Am. 2002; 84(9): 1605-12.
12. Moja L, Piatti A, Pecoraro V, et al. Timing matters in hip fracture surgery: patients operated within 48 hours have better outcomes. A meta-analysis and meta-regression of over 190,000 patients. PLoS One. 2012; 7(10): e46175.
13. Simunovic N, Devereaux PJ, Sprague S, et al. Effect of early surgery after hip fracture on mortality and complications: systematic review and meta-analysis. CMAJ. 2010; 182(15): 1609-16.
14. Schmidt AH, Asnis SE, Haidukewych Gi, et al. Femoral neck fractures. Instr Course Lect. 2005; 54: 417-45.
15. Parker MJ. Missed hip fractures. Arch Emerg Med. 1992; 9(1): 23-7.
16. Eastwood HD. Delayed diagnosis of femoral-neck fractures in the elderly. Age Ageing. 1987; 16(6): 378-82.
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ลิขสิทธิ์บทความเป็นของผู้เขียนบทความ แต่หากผลงานของท่านได้รับการพิจารณาตีพิมพ์ลงวารสารแพทย์เขต 4-5 จะคงไว้ซึ่งสิทธิ์ในการตีพิมพ์ครั้งแรกด้วยเหตุที่บทความจะปรากฎในวารสารที่เข้าถึงได้ จึงอนุญาตให้นำบทความในวารสารไปใช้ประโยชน์ได้ในเชิงวิชาการโดยจำเป็นต้องมีการอ้างอิงถึงชื่อวารสารอย่างถูกต้อง แต่ไม่อนุญาตให้นำไปใช้ในเชิงพาณิชย์
