Résumé
Delayed diagnosis of musculoskeletal injury in multitrauma patients may potentially cause functional or cosmetic sequelae remaining for the rest of survivors life. Identification of factors which hide injuries from early diagnosis in multitrauma patients will decrease their occurrence and prevent many functional disabilities and cosmetic sequelae. We planned this study to assess the reasons for injury concealment in multitrauma patients and provide resolutions to reduce them. This cross-sectional study on 487 patients was carried out in Tabriz Shohada Hospital from February 2004 to February 2005. After collection of needed data, a questionnaire was filled for every multitrauma patient who had a missed injury. The relative frequency of multitrauma was 18.51% among all studied trauma patients [487 cases], but 7.6% of included patients [28 from 367 trauma cases] had missed injury [ies]. 32 missed injuries were found in 28 patients. Most injuries were musculoskeletal, involving the distal part of the limbs [feet, hands, wrists and ankles]. Fracture was the most common type of musculoskeletal injury [19 out of 32 missed injuries]. Causes that lead to concealment of injuries were founded to be inadequate physical and / or, radiographic examinations, commonly after severe penetrating injuries which are mostly due to motorcycle accident. Most of the missed injuries have been ultimately diagnosed upon the patient's complaints in hospital wards, within 1 to 30 days after trauma. We can prevent missing of injuries by complete and accurate physical examination and perfect radiographic evaluation according to the standard protocols. Repetitive serial examinations during admissions and after discharge can reveal missed injuries