Orthopaedic Surgery Negligence

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If you have suffered an injury from negligent orthopaedic surgery, our medical negligence solicitors can provide advice on your rights to compensation. For obligation-legal assistance, call our helpine or complete the contact form.

Orthopaedic Surgeons

The Consultant Orthopaedic Surgeon deals with operations and procedures involving the bones and joints. Some Consultant Orthopaedic Surgeons deal mainly with trauma patients in Emergency Departments. Some Consultant Orthopaedic Surgeons have a special interest in hand, knee, hip, shoulder or ankle surgery. Some also specialise in operations on children (Paediatric Orthopaedic Surgery).

Orthopaedic Surgeons deal with a range of fractures- including fractured clavicle, rib, scaphoid, humerus, radius, ulna, femur and tibia as well as fractures involving the small bones of the hands and feet. They deal with  trauma to the bones as well as reconstructive surgery of the bones and joints. They also deal with neck and back injuries (cervical, thoracic, lumbar, sacral spine), spinal trauma, soft tissue as well as ligament injuries and joint reconstruction. Reconstructive surgery involves hip and knee replacement operations as well as surgery on the ligaments of the knee, ankle, shoulder and hand.

Dislocation

A dislocation occurs when the surfaces of a joint are totally displaced, one from the other. If there is partial separation of the joint surfaces, it is called a subluxation. Dislocations are usually caused by a sudden impact to the joint. This usually occurs following a blow, fall, or other trauma.

A dislocated joint may be:

• Visibly out-of-place, discoloured, or misshapen
• Shape of the joint may be distorted
• Limited in movement
• Swollen or bruised
• Intensely painful, especially if you try to use the joint or bear weight on it

Joints which are commonly dislocated include:

• Shoulder
• Hip
• Elbow
• Knee (patellar dislocation)
• Ankle
• Finger

A shoulder dislocation is an injury that occurs when the top of the arm bone (humerus) loses contact with the shoulder blade (scapula). A shoulder dislocation generally occurs after an injury such as a fall or a sports-related injury. When the dislocation is diagnosed, the shoulder must be "reduced," or put back in place.

A patella that does not track evenly within its groove on the femur is called an unstable knee.

A finger dislocation is a displacement of the bones of the finger from their normal position. When a joint is dislocated, the normal alignment of the finger is altered, and the joint must be put back into place. Once the joint has been put back into position, the finger is splinted to allow the ligaments and joint capsule to heal.

An elbow dislocation is an injury to the elbow joint so that adjoining bones are displaced from their normal position and no longer touch each other. It is usually a surgical emergency because damage to nerves and blood vessels is common and severe. A doctor will usually aspirate blood from the dislocated elbow and reposition the bones with manipulation under general anaesthesia.  Surgery is sometimes needed to restore the elbow to its normal position and repair tendons and collateral ligament. Acute or recurring dislocations may require surgical reconstruction or replacement of the elbow.

Dislocations are diagnosed by x-ray. Medical treatment involves manipulating the bones of the joint back into their correct position as soon as possible. This can sometimes be done quite easily, however, if there are severely damaged ligaments and cartilages around the joint, surgical repair may be necessary.

Complications may occur when a dislocation happens. Cartilages, ligaments and possibly muscles and tendons around the joint will be stretched, strained or torn. It is possible that a nerve or blood vessel may become pinched. There may even be premature development of arthritis.

Once dislocated, a joint may dislocate very easily in the future. A joint that dislocates easily and repeatedly may require surgical intervention to tighten the muscles and ligaments around it. A dislocation may also be associated with a fracture.

Fracture

The human body contains 206 bones. When a bone breaks, it is called a fracture. It may be caused by excessive force (a blow), pressure or twisting (eg during a slip, trip or fall) applied to a bone.

There are several different types of fractures:

• Simple fracture: a single break across the whole width of the bone.
• Hair line fracture: tiny crack part way through a bone.
• Avulsion fracture: a small fragment of bone is pulled off at the point where a muscle, ligament or tendon attaches.
• Compound fracture: the skin over the fracture is broken by bone end.
• Depressed fracture: a piece of bone (often in the skull) is pushed in below the level of surrounding bone
• Impacted fracture: this is the forcible shortening of a bone as one fragment of bone is pushed into another.
• Comminuted fracture: 2, 3 or more breaks in the one bone.
• Greenstick fracture: when the break is only one side of the bone and the bone bends
• Transverse fracture: when the break is at a right angle to the length of the bone.

When a fracture occurs, there will usually be pain, swelling and tenderness at the site of the fracture, bruising over or below the fracture, loss of function of the limb or area. X-rays will detect most types of fractures, but sometimes, a CT scan or bone scan is required.

The exact treatment will vary considerably from one bone to another, with some fractures requiring minimal fixation (e.g upper arm bone), while others require major surgery (e.g hip fracture).

In order for the fracture to heal as quickly as possible, however, without any deformity, the bones must sometimes be first put back in proper position. This is called "reduction" and involves putting the broken bone in a cast, after the doctor manipulates the bone into proper alignment. The use of casts is also know as external fixation. For some breaks, immobilisation through the use of a cast may be enough to facilitate healing. The majority of fractures can be successfully treated with an eventual return to full function of the bone. However, in some cases, even when a fracture is corrected by surgery, there may be chronic pain at the fracture site, recurring fractures requiring surgery. Surgery is known as internal fixation. The affected bone is usually fixed in position with wires, rods, plates, or screws.

The time needed for complete healing varies. Bones generally heal more slowly the older we get. Some broken bones, especially in children, heal within a couple of weeks. Others may take months or even years.

Compound fractures are susceptible to infections and death of bone tissue can occur in small fragments. Other complications of broken bones include traumatic arthritis, compartment syndrome, nerve damage and damage to blood vessels.

Orthopaedic Negligence Claims

Examples of areas where there have been claims of medical negligence:

• failure to diagnose or delay in diagnosing a fracture
• poor outcome following negligent treatment or management of a fracture
• infection following a bone operation or procedure
• negligent management of shoulder injuries
• missed slipped femoral epiphysis
• poor outcome following a negligently performed hip replacement
• poor outcome following a negligently performed knee operation and injuries suffered following orthopaedic surgery (including back surgery,  surgery involving the cervical spine, thoracic spine or lumbar spine, osteotomy, compartment syndrome, and cauda equina syndrome).

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