Commonly missed injures in Orthopedic.pptx

orthopedic errors

1. Commonly missed injures in Orthopedic Dr Walid Samy Fathy Orthopedic & Traumatology specialist Alhelal Hospita

2. Disclosure

3. Our work environment

4. Chaotic

5. Distraction

6. Objectives Recognize the most frequent Xrays missed by ED health care professionals Understands the factors that lead to misinterpretation Learn about some radiographic signs that allows one to mitigate the rate of misses Apply tools learned to reduce the miss rate

7. Pitfalls of ER X-Rays Incorrect interpretation (interpretation errors) Inadequate (suboptimal) images Over‐reliance on radiography Inadequate clinical examination

8. Misinterpretation of radiographs Failure to recognize subtle signs of injury Misinterpreting radiographic variants as acute injuries Missed second injury (“satisfaction of search” error)

9. Inadequate radiographs Inadequate views (technically suboptimal) Incomplete radiographic series (missing views) Failure to order supplementary views or other studies (MDCT, MRI)

10. Clinical examination inadequate Radiography of the incorrect region (hand/wrist, foot/ankle) Missed soft tissue injury (neurovascular, compartment syndrome, ligamentous) Missed second injury Failure to obtain radiographs

11. start

12. The Power of the Axillary View!

13. Which is the normal?

14. Closed fist

15. 43

16. 44

17. How to avoid misinterpretation of an Xray 48

18. Examine the patient first 49

19. The clinical findings trump everything 50

20. Examine the joint above and below the fracture 51

21. Avoid being distracted 52

22. Know what you are looking for 53

23. Obtain multiple views of the same are of interest 54

24. Be familiar with specific radiographic signs 55

25. Look for the second…or third fracture 56

26. Look for the ring disruption 57

27. Pay more attention to the common misses 58

28. Thank you 59