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Undiagnosed Scaphoid Fractures
One of the frequent causes for complaint against an Accident and Emergency department is the failure to diagnose a fracture. The patient is invariably examined and sometimes x-rayed but discharged home often with a diagnosis of a sprain and some pain killers. Sometimes the patient is offered a follow up appointment at the fracture clinic.
Problems arise for a variety of reasons but often because either the doctor is inexperienced, the fracture was in fact difficult to see on the x-ray or the view taken on the x-ray was wrong for the type of fracture and as a result it was not seen. Sometimes x-rays are not taken at all because the description of the accident and the symptoms were not typical of a fracture. Because of the variety of reasons why a fracture could be missed, not all missed fracture cases will give rise to a claim. In addition there are some cases where the fracture was so nasty that even had it been treated promptly it is unlikely that the patient would have achieved a good result.
One of the areas however that has particular problems if not diagnosed quickly is the missed scaphoid fracture. The scaphoid is a small bone in the wrist and evidence has shown that failure to diagnose such a fracture promptly can lead to serious consequences. A scaphoid fracture is most typical in young men where there is a fall with typically a hyperextension (forcing backwards). As a result of this particular risk specific guidelines have been issued as to how such a potential fracture should be diagnosed with certain x-rays being undertaken where there is suspicion of such a fracture.
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