Delay in diagnosis and treatment of scaphoid fracture

Delay In Diagnosis And Treatment Of Scaphoid Fracture

Mrs W suffered a fall while BMX riding on 2 August 2009 and attended the Accident and Emergency Department at Broomfield hospital. Scaphoid x-rays were performed which confirmed a fracture to the left wrist. Mrs W was put in plaster and advised to attend her local Accident and Emergency Department.

On 3 August 2009 Mrs W attended Accident and Emergency at Milton Keynes hospital with pain in her right wrist. Scaphoid x-rays were taken which queried a scaphoid fracture. A doctor examined the x-rays and advised that there was no fracture to the right wrist. The doctor requested that the left wrist be placed in a back slab and the right wrist in a support for 1 week until the bruising subsided.

Mrs W attended a follow up appointment at the Fracture Clinic on 10 August 2009. The right wrist was not examined, and only previous x-rays were reviewed.  The doctor assured her that there was no fracture and organised for her left wrist to be re-plastered for a further seven weeks.

The pain in her right wrist increased over the next few weeks and after 5 weeks she attended her GP who suspected a scaphoid fracture. She attended Buckingham hospital for a further x-ray. While waiting for the results of the x-ray, Mrs W attended another appointment at the fracture clinic. The doctor examined her right wrist and due to the pain she was in, another x-ray was performed. The x-ray revealed a fracture which had developed into a hole in the scaphoid bone. She was informed that the Accident and Emergency Department had missed the initial fracture. The left wrist was removed from plaster and the right wrist was placed in plaster for a further 8 weeks.

After 8 weeks the cast was removed and the wrist was re-x-rayed. The fracture had not healed and an MRI revealed poor blood supply to the scaphoid bone and ligament damage.

The Defendant admitted that the scaphoid fracture should have been identified on 10th August 2009 and that if it had been Mrs W would have recovered with no disability.

Medico legal expert opinion from a hand surgeon also confirmed that if Mrs W was treated promptly,
she would have required only 6-8 weeks in a plaster and then a further 6 weeks of physiotherapy,
following which her wrist would have been normal with no disability.

As a result in the delay in diagnosis of the fracture, Mrs W sustained a non-union of the
scaphoid and had to undergo surgery on 9th February 2010 which involved taking a bone graft from
her left hip.  In January 2011 she had to undergo further surgery and a revision fixation to the
right scaphoid and a radial styloidectomy and bone graft were performed. 

Mrs W’s wrist has improved since the surgery but she still suffers from stiffness and pain when
using her right hand for tasks such as typing and lifting and gripping objects.  She has also had to
give up her pre-accident hobbies of BMX riding, swimming and playing badminton.

The case settled for a sum of £75,000.

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