Strategies to Reduce Missed Fracture Diagnoses: Insights from Medical Malpractice Cases in China

Document Type : LETTER TO THE EDITOR

Author

Department of Orthopaedic Surgery, Zibo Hospital of Traditional Chinese Medicine (Zibo Orthopedic Hospital), Zibo, Shandong, China

Abstract

Missed fractures are a frequent source of malpractice claims in China. We reviewed 52 legal judgments (2021-2023) involving missed fractures to characterize the epidemiology, injury patterns, and diagnostic errors. Most patients were middle-aged males injured in traffic accidents. Lower extremity fractures accounted for over half of missed diagnoses, especially femoral neck (35.4%) and ankle/foot (16.7%). 85.4% were non-displaced fractures, often originally diagnosed in emergency departments. Physicians were found negligent in 63.5% of cases. Occult fractures are prone to underdiagnosis as soft tissue injuries. To reduce errors, physicians should thoroughly evaluate injury mechanisms, perform appropriate radiologic studies, immobilize when uncertain, and ensure follow-up. Quality improvement initiatives are needed to enhance fracture detection. Findings highlight the need for heightened suspicion and diligent radiographic assessment to avoid delayed or missed fracture diagnoses.

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References

  1. Yue L, Sun MS, Mu GZ, et al. Spine-related malpractice claims in China: a 2-year national analysis. Global Spine J. 2023; 13(6):1566-75. doi: 10.1177/21925682211041048.
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The Archives of Bone and Joint Surgery
Volume 12, Issue 1
January 2024
Pages 78-79

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History

  • Receive Date: 08 November 2023
  • Revise Date: 31 December 2023
  • Accept Date: 11 November 2023

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