Plain film fracture detection rate of trauma clinicians on Lodox bodygram
This was a retrospective review to ascertain the plain film fracture detection rate of non-radiologist trauma clinicians when interpreting Lodox bodygram images in adult trauma patients. Customised searches of the Picture Archiving and Communications Systems (PACS) of two tertiary academic hospitals in the Western Cape, South Africa, were conducted to retrieve all adult trauma patients (aged 18+ years) who had Lodox bodygram scans as part of their initial workup on presentation to either of the two Level 1 Trauma Units over two consecutive months. Information collected included age, sex, mechanism of trauma, location of all fractures or dislocations visible on the Lodox bodygram and whether the patient was intubated or not. The bodygram images (which are not routinely reported by radiologists) were retrospectively reviewed by two radiologists, who noted the locations of all fractures visible on Lodox (gold standard). The follow-up imaging sequence on the PACS system was then analysed to see which of the fractures visible on Lodox received dedicated follow-up imaging (radiographs/CT/MR) since the single projection Lodox bodygram is insufficient for full characterization of the injury. Fractures seen on Lodox but without additional dedicated imaging were deemed as missed. Cases which were unclear or where follow-up imaging was delayed were clarified by review of the clinical notes. Generalised Fischer Exact Test assessed any association between the fracture site and failure of detection. An orthopaedic surgeon was consulted to ascertain which of the missed fractures needed surgical treatment. Data included are: Excel Spreadsheet: Complete Dataset Complete dataset for our study in table form. Columns are self-explanatory with totals tallied below. Excel Spreadsheet: Statistical results The results of the Generalised Fischer Exact Test used to assess any association between the fracture site and failure of detection Figure 2: Selected examples of subtle missed fractures, description included in accompanying Word document of the same name.