La scintigraphie squelettique comme test de dépistage de fractures méconnues chez les patients sévèrement traumatisés - 06/12/14
Bone scan as a screening test for missed fractures in severely injured patients
, K. Jung , J. Kim , J. Kwon ⁎ Abstract |
Background |
In many cases, patients with severe blunt trauma have multiple fractures throughout the body. These fractures are not often detectable by history or physical examination, and their diagnosis can be delayed or even missed. Thus, screening test fractures of the whole body is required after initial management. We performed this study to evaluate the reliability of bone scans for detecting missed fractures in patients with multiple severe traumas and we analyzed the causes of missed fractures by using bone scans.
Hypothesis |
A bone scan is useful as a screening test for fractures of the entire body of severe trauma patients who are passed the acute phase.
Material and methods |
We reviewed the electronic medical records of severe trauma patients who underwent a bone scan from September 2009 to December 2010. Demographic and medical data were compared and statistically analyzed to determine whether missed fractures were detected after bone scans in the two groups.
Results |
A total of 382 patients who had an injury severity score [ISS] greater than 16 points with multiple traumas visited the emergency room. One hundred and thirty-one patients underwent bone scans and 81 patients were identified with missed fractures by bone scans. The most frequent location for missed fractures was the rib area (55 cases, 41.98 %), followed by the extremities (42 cases, 32.06 %). The missed fractures that required surgery or splint were most common in extremities (11 cases). In univariate analysis, higher ISS scores and mechanism of injury were related with the probability that missed fractures would be found with a bone scan. The ISS score was statistically significant in multivariate analysis.
Discussion |
Bone scan is an effective method of detecting missed fractures among patients with multiple severe traumas.
Level of evidence |
Level IV, retrospective study.
Il testo completo di questo articolo è disponibile in PDF.Keywords : Bone scan, Trauma, Missed fracture, Diagnosis
| ☆ | Cet article peut être consulté in extenso dans la version anglaise de la revue Orthopaedics & Traumatology: Surgery & Research sur Science Direct (www.sciencedirect.com/) en utilisant le DOI cidessus. |
Vol 100 - N° 8
P. 682 - Dicembre 2014 Ritorno al numero
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