Is It Always Negligent To Miss a Scaphoid Fracture?
Missed fractures and dislocations are the cause of several legal claims. Whether you have a claim for a clinician missing a scaphoid fracture will come down to what investigations were carried out.
Symptoms of a Scaphoid Fracture
A scaphoid fracture usually happens after falling onto an outstretched hand. Symptoms include:
- Pain/swelling between the base of the thumb and the wrist
- Pain when trying to grip or hold something
- Pain when moving the wrist or thumb
HOW IS A SCAPHOID FRACTURE DIAGNOSED?
When you presented with your injury three enquiries should have been carried out:
- History: You should have been asked to explain how the injury was caused. This gives an idea of the level of force and the ‘direction’ of the injury.
- Physical Examination: A proper physical examination must be carried out. They should have looked at the location of the pain/swelling/bruising. They should have asked when the pain increases or decreases and whether there is any loss of movement.
- X-rays: If a fracture is suspected, x-rays should have been taken. In the case of a suspected scaphoid fracture, x-rays from four different angles should be taken.
A scaphoid fracture might not be visible on x-rays until 10 days after the initial injury. If it is not seen on the first x-ray, you should be x-rayed again in 10 to 14 days or a MRI or have a CT scan.
What is the Treatment for a Scaphoid Fracture?
Treatment depends on the location of the fracture, the type of the fracture and how long ago the fracture occurred.
If the fracture is ‘non-displaced,’ meaning the bone is still where it should be, it can usually be treated successfully with a cast. In some specific fractures or if the fracture is ‘displaced,’ meaning the ends of the bone have shifted, surgery might be more appropriate.
If there is doubt then an opinion of a more senior clinician, or an orthopaedic specialist, should be sought as soon as possible. Otherwise, your wrist should be put into a splint and you should be referred for review in the next fracture or emergency department clinic.
Scaphoid fracture claims
Failing to diagnose a scaphoid fracture, or a delay in treatment, can have potentially devastating effects – including non-union of the fracture, death of bone tissue (due to a lack of blood supply) or potentially fusion of the wrist.
In answer to the question in the title – no, it is not always negligent to miss a scaphoid fracture. However, if the correct investigations were not carried out then there may be a claim to investigate.
If you would like advice about a claim, speak to Enable Law’s specialist clinical negligence solicitors in confidence today by clicking here.