Lisfranc injury: How frequently does it get missed?

Abstract

AbstractsFigure 1 Breakdown of trauma work load.Methods: We wish to present data from medical retrieval missions carried out over the first 18 months of our service (October 2004-April 2006. Data was collected prospectively for all patients on a unique data capture sheet. Patients were followed up by a combination of direct review and case note review.Results: During this time we attended 58 patients of whom, 22 (38%) had a primary traumatic diagnosis.Thirteen out of 22 (57%) required emergency anaesthesia and ventilation. Fifteen out of 22 (65%) required a procedure other than emergency anaesthesia.A breakdown of the trauma workload is given in Fig. 1.Patients outcomes were assessed using Standard ISS and TRISS methodology. The median ISS was 25 (range 2-59) with 17/22 (77%) patients having ISS > 15.Discussion: Our data from first 18 months of the EMRS supports the concept of medical retrieval within rural Scotland. The severity of injury in subjects examined in this study clearly demonstrates a clinical need for rapid access to specialist and advanced medical interventions for patients in remote communities in Scotland. Prior to the introduction of the EMRS similar patients with major trauma have regularly been transferred by air for prolonged periods without pre-transfer stabilisation, most importantly without definitive airway maintenance and protection. This level of care and transfer should no longer be acceptable for critically injured patients.