Reviewed by Independent editorial panelLast reviewed April 2026 · Next review October 2026
Missed fractures are among the most common clinical negligence claims in emergency medicine and orthopaedics. Fractures are missed in A&E, GP surgeries, and on ward rounds — particularly in the elderly, in children, and in anatomically challenging sites. When a fracture is missed and not treated appropriately, the consequences range from prolonged pain and malunion (a fracture healing in the wrong position), to avascular necrosis, compartment syndrome, and permanent disability.
Fractures most commonly missed
| Fracture site | Typical mechanism | Consequence of missed diagnosis |
|---|---|---|
| Scaphoid | Fall on outstretched hand | Avascular necrosis, non-union |
| Femoral neck (hip) | Fall in elderly | Avascular necrosis, delayed mobility, death |
| Odontoid (C2) | High-energy trauma or elderly fall | Spinal cord injury if neck not immobilised |
| Tibial plateau | Twisting injury to knee | Articular damage, knee instability |
| Stress fracture (tibia, metatarsal, femur) | Overuse | Progression to complete fracture |
| Children's fractures (buckle, greenstick) | Low-energy falls | Malunion if not splinted |
| Pelvis fractures in elderly | Low-energy falls | Prolonged pain, haemorrhage in some |
Frequently asked questions
Can I claim if my fracture was missed on X-ray?
Yes — if a competent radiologist or emergency medicine clinician would have identified the fracture from the imaging available, or would have arranged CT or MRI when the plain X-ray was equivocal.