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Posted on 21st April 2017

What are the most commonly missed bone fractures

Research says that one in 100 people will break a bone every year in the UK and more than half of the 20 million people visiting A&E must have an x-ray.

In 2002 the British Medical Journal published a study that showed junior doctors in A&E miss up to 39 per cent of fractures and clinically significant abnormalities on X-rays.

A study at North Tyneside General found that people who had their x-ray reviewed by an A&E doctor were 10 times more likely to be discharged with the all clear – despite having a fracture.

‘Numerous studies have shown that failure to detect a fracture on an X-ray is the most common diagnostic error made in A&E,’ Michael Kelly, consultant orthopaedic trauma surgeon at North Bristol NHS Trust, told The Daily Mail. 

 ‘At the very least, people suffer prolonged pain and inconvenience,’ says Mr Kelly, ‘but it can also lead to ‘chronic functional limitation with long-term pain, early symptoms of osteoarthritis or a stiff joint.’


If you think you or a loved one have suffered because a broken bone has been missed and you haven’t received the right treatment, speak to one of our team today. We can help you get the answers you need.


Having an expert review your x-ray

Many hospitals have a procedure where a radiologist will review your x-ray after an A&E doctor. Radiologists are specialists in x-rays and often spot breaks missed by doctors.

However, there is a shortage of specialists and in 2014 the Royal College of Radiologist found that 300,000 patients were waiting more than a month to get their x-ray analysed. By this point if there was a fracture the damage would be done.

What can happen if a broken bone isn’t treated?

If a bone fracture is missed and not treated quickly then the bone can heal, or fuse together, in the wrong position. This may lead to complex surgery to fix it in the future, as well as a lot of extra pain. 

If surgery is not required, then you may find you suffer restricted movement in the area where your fracture was missed, and may even suffer disability because of it. 

Can an x ray miss a fracture

Missed ankle fracture on x-ray

It can be difficult to tell the difference between a minor break and a sprain, therefore ankle fractures are commonly missed on x-rays in A&E departments.

Symptoms of a broken ankle

According the NHS choices the symptoms of a broken ankle are

  • Severe pain and tenderness
  • Bruising
  • Swelling
  • Difficulty moving your foot
  • Unable to put weight onto your foot
  • Our ankle is an odd shape (sign of dislocation)
  • You feel faint, dizzy or sick from the pain

Most commonly missed fractures – wrist fractures

In your wrist, there is a tiny bone called a scaphoid bone, it is found near the base of your thumb. This is often missed on x-rays when fractured.

How do you fracture your scaphoid?

Fractures to this part of your wrist are common when you fall onto an outstretched hand. Your hand and wrist are pushed back with the force of your fall.

This fracture is often missed because the scaphoid bone is inside the wrist joint and can be difficult to see. There are often no other symptoms such as swelling.

Problems caused by a missed scaphoid fracture

Although it is a tiny bone it can cause a lot of problems if broken and left untreated.

These issues include:

  • Reduced grip in the injured hand
  • Reduced range of motion in the injured wrist
  • The bone can fail to fuse together, or fuses together incorrectly and causes pain.
  • It can lead to Osteoarthritis
  • The blood flow to the bone can be disrupted and it can die.

More serious issues include:

  • Compartment syndrome which results in amputation if not treated quickly
  • Fat Embolism occurring which can lead to death if not treated
  • Deep vein thrombosis
  • An inflammation of the bone marrow caused by infection because of the break.

Guidelines issued by the College of Emergency Medicine recommend that patients with a suspected scaphoid fracture and tenderness in the wrist area should be offered a Magnetic Resonance Imaging (MRI) scan even if the X-ray comes back clear.

If you think you or a loved one have suffered because a broken bone has been missed and you haven’t received the right treatment, speak to one of our team today. We can help you get the answers you need. 

Further Information