Substantial damages recovered for injuries suffered as a consequence of failed orthopaedic surgery

Richard Malloy a Solicitor at GAD Legal Solicitors recovers substantial damages for injuries suffered as a consequence failed orthopaedic surgery at Ysbyty Gwynedd Hospital in Bangor, Wales which is a district general hospital operated by Betsi Cadwaladr University Health Board.

Facts of the case

On the 19^th January our client fell at her home and injured her left leg.  She was taken to Ysbyty Gwynedd by ambulance where it was diagnosed that she had suffered closed fractures to her left distal tibia and fibula.

She underwent surgery to stabilise the fracture. This involved screwing the tibial fracture and inserting a plate and screws around the fibula fracture.  She was later discharged home in a cast.

On 7^th February the cast was removed and her leg was placed into a below knee brace.    She was encouraged not to weight bear.

At home she inadvertently put weight through the leg and she experienced swelling of her ankle.   She immediately attended A&E.  Some redness of the ankle was noted but no x-rays were performed.  She was discharged home with antibiotics.

She attended the clinic on 7^th March and a clear deformity was observed.  X-rays confirmed that there had been complete failure of the metal with a pull-out from the bone of several screws, resulting in a significant deformity of the ankle. She was advised that it was now a complex problem.   Surgery was performed on 11^th March when the metalwork was removed and an external fixator was placed.  This was a temporary measure before she was transferred to The Royal Liverpool and Broadgreen University Hospitals NHS Trust for reconstructive surgery which was undertaken on 3^rd April.

The external fixator applied at Royal Liverpool Hospital healed well and the frame was removed on or around 5^th July and she was fitted in an air cast boot and was mobilising with the aid of crutches.

Following removal of the frame, she underwent physiotherapy. 

She was offered further surgery in the form of ankle arthroscopy and also leg lengthening procedure because as the result of her treatment, the leg was left approximately 2 to 3cms short.

Following independent expert evidence from an Orthopaedic Surgeon it was admitted by the Hospital Board that the original fixation to stabilise the fracture which involved screwing the tibial fracture and inserting a plate and screws around the fibial fracture was undertaken negligently in that the fixation was not effectively applied.   The technique employed with the insertion of 4 screws was a very high risk strategy in managing a fracture and was insufficient to control movement of the fracture fragments and therefore, was always doomed to failure. 

Absent the Defendant’s failures and in the event that the original fixation had been adequately applied and the fracture securely fixed with appropriate techniques followed by a reasonable prolonged protection in plaster rather than a brace, there would have been satisfactory union on the balance of probability. 

The failure in the tibial fracture led to an overall failure of the fracture construct and subsequent migration of the fibula plate.

It led to our client having prolonged treatment, additional significant surgery, a much poorer outcome, increased risk of degenerative change in the joint and led to her being left with a limb that is short.

The Defendant made an early offer to settle the whole of the claim in the sum of £15,000.

That offer was not accepted and we obtained independent expert evidence in the fields of;