A missed injury in multiple trauma patient-is it avoidable?

Area of Science:

• Orthopedic Surgery
• Trauma Management

Background:

• Polytrauma patients often present with complex injuries.
• Secondary surveys are standard but may miss subtle fractures.

Purpose of the Study:

• To report a case of a missed ankle fracture in a polytrauma patient.
• To emphasize the importance of comprehensive injury assessment.

Main Methods:

• Case report of a 24-year-old male with bilateral femur and tibia fractures.
• Surgical intervention and clinical outcome assessment.
• Review of diagnostic surveys conducted.

Main Results:

• Initial surgery achieved satisfactory outcomes for femur and tibia fractures.
• A displaced ankle fracture was initially missed despite a thorough secondary survey.
• The missed injury was identified later, highlighting a diagnostic gap.

Conclusions:

• Undetected injuries can occur even after thorough secondary surveys in polytrauma.
• A tertiary survey is crucial for routine assessment in all polytrauma cases.
• Implementing tertiary surveys can significantly reduce the incidence of missed injuries.