[Failing primary clinical investigation is common in missed hip fractures]

Failing primary clinical investigation is common in missed hip fractures Diagnostic errors in 43 patients with hip fracture handled by the Swedish Health and Social Care Inspectorate were analyzed. Diagnostic errors were most likely a consequence of insufficient initial history, examination and/or radiologic examination. The most common isolated cause was delayed examination by a physician outside of a hospital setting. A substantial number of diagnostic errors were related to the radiological examination itself. Atypical symptoms were a minor cause of diagnostic errors. Since mortality in hip fracture is dependent on early surgery, preferably performed within 24 hours, diagnostic delay could prove disastrous to the patient.