Morrison C M, Thompson N W, Herbert K J, Brennen M D
The Northern Ireland Plastic and Maxillofacial Service, The Ulster Hospital, Upper Newtownards Road, Dundonald, Belfast BT16 1RH.
Ulster Med J. 2003 May;72(1):22-5.
A prospective study of 500 consecutive patients referred from accident and emergency departments in Northern Ireland with acute hand injuries was performed to assess the incidence of missed injuries. An injury was 'missed' if a patient was receiving inappropriate treatment or returned due to persistent symptoms despite being examined, treated and discharged. There were 16 (3.2%) missed injuries. Seven involved tendon only, four were isolated nerve injuries and four were mixed tendon and nerve injuries. The remaining case was a ruptured ulnar collateral ligament of the thumb metacarpophalangeal joint. Thirteen injuries were open, with a glass laceration being the most common mechanism of injury. The time to detection of a missed injury was on average 11 days (range 1-62 days). Missed hand injuries in Northern Ireland are uncommon but do occur. A thorough clinical examination and accurate injury documentation remain fundamental in their prevention.
对北爱尔兰急诊科转诊的500例连续急性手部损伤患者进行了一项前瞻性研究，以评估漏诊损伤的发生率。如果患者接受了不适当的治疗，或者尽管经过检查、治疗和出院，但因持续症状而复诊，则该损伤被视为“漏诊”。共有16例（3.2%）漏诊损伤。其中7例仅累及肌腱，4例为孤立性神经损伤，4例为肌腱和神经混合损伤。其余1例为拇指掌指关节尺侧副韧带断裂。13例损伤为开放性损伤，玻璃割伤是最常见的损伤机制。漏诊损伤的平均发现时间为11天（范围1 - 62天）。北爱尔兰的手部漏诊损伤并不常见，但确实存在。全面的临床检查和准确的损伤记录仍然是预防此类损伤的根本。
