Document Detail

The suspected scaphoid fracture. How useful is a unit policy?
MedLine Citation:
PMID:  9725065     Owner:  NLM     Status:  MEDLINE    
The records of 196 patients presenting with a clinical suspicion of scaphoid injury were reviewed to evaluate how junior accident and emergency doctors in a teaching hospital managed these patients. The management that was provided was assessed, and it was ascertained whether the presence of a unit policy meant that accident and emergency junior trainees managed patients accordingly. We found that 82% of patients were immobilized for 2 to 13 weeks, with 60 patients (37%) being immobilized for 6 weeks or more. Of the 196 patients presenting with clinical suspicion of scaphoid fracture, a definite scaphoid fracture was found in only 12%. Less than half of the patients (46%) were reviewed by senior accident and emergency doctors or by senior orthopaedic surgeons. Despite the presence of a unit policy, patients were being immobilized for prolonged periods in the absence of a radiographically evident scaphoid fracture. Advice from more experienced members of the staff was not being sought in dubious cases.
J N'Dow; K N'Dow; N Maffulli; G Page
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Publication Detail:
Type:  Journal Article    
Journal Detail:
Title:  Bulletin (Hospital for Joint Diseases (New York, N.Y.))     Volume:  57     ISSN:  0018-5647     ISO Abbreviation:  Bull Hosp Jt Dis     Publication Date:  1998  
Date Detail:
Created Date:  1998-10-29     Completed Date:  1998-10-29     Revised Date:  2005-11-17    
Medline Journal Info:
Nlm Unique ID:  9215948     Medline TA:  Bull Hosp Jt Dis     Country:  UNITED STATES    
Other Details:
Languages:  eng     Pagination:  93-5     Citation Subset:  IM    
Department of Accident and Emergency, Aberdeen Royal Hospitals NHS Trust, Foresterhill, Scotland.
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MeSH Terms
Carpal Bones / injuries*,  radiography
Casts, Surgical
Clinical Protocols
Diagnostic Errors
Emergency Service, Hospital / standards*
Fractures, Bone / radiography,  therapy*
Hospitals, Teaching / standards
Medical Staff, Hospital / education,  standards
Physical Examination
Referral and Consultation

From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine

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