ArticleClinical and experimental emergency medicine2015
Missed clavicle fractures on anterior-posterior views of skull X-rays: a retrospective, observational, and descriptive study.
Article in Clinical and experimental emergency medicine, 2015. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.
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5 authors at 3 institutions in 1 country.
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Abstract
objectiveThe clavicle is almost always seen in skull X-rays of infants. The objectives of this study were to determine how often the clavicle and clavicle fractures are visible but missed on the skull anterior-posterior view (skull AP) of infants and which factors are associated with missing the diagnosis.
methodsWe retrospectively studied patients aged 1 year or younger who had a skull AP taken for any injury survey at a single urban, academic hospital between April 1999 and July 2012. Outcomes of interest were the numbers and percentages of visible clavicles; clavicle fractures, including missed ones on skull AP; and the factors associated with missing the diagnosis of a clavicle fracture.
resultsBoth clavicles were visible in 734 patients (89.6%). Of these, 10 patients (1.4%) had confirmed clavicle fractures, and 6 patients (0.8%) had fractures that were missed at presentation. Although we tried to determine the factors that might be associated with missed diagnoses, including age <6 months, male sex, blocking by guardian's hands, associated skull fractures, and mechanism of injury, none was significantly associated with missed clavicle fractures.
conclusionThe clavicles were recognizable on skull X-rays in most cases. Therefore, one should check the clavicles when reading skull X-rays.
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