To evaluate the incidence of orthopaedic injuries and develop guidelines for routine radiologic examinations in patients with traumatic brain injury in order to reduce the incidence of delayed diagnosis.

For this study, 175 out of 720 traumatic brain injury patients, who were treated at Sun General Hospital from May 1994 through December 1997, were analyzed. The incidences of musculoskeletal injury and delayed diagnosis were checked.

Clavicle fracture occurred most frequently, followed by tibia-fibular fracture, femur fracture, pelvic fracture or hip fracture-dislocation, axial spine fracture, radius-ulnar fracture, knee ligament injury, fracture of the hand and humerus. The overall incidence of delayed diagnosis was 14 percent (24 patients) . And multiple (more than 2) injuries occurred in 43 patients (24%).

The data of this study suggest that a radiologic survey, including X-rays of chest, long bones of the lower extremites, pelvis (both hips) and entire axial spine, should be obtained in patients with traumatic brain injury. Also careful examination of the knee should be included.