Inadequate management of hand fracture

Medical history

A 22-year-old man sustained fracture dislocations of the right hand when his motorcycle collided with a car. X-Rays were seen to show a fracture of the shaft of the fourth metacarpal, with a subluxation of the carpo-metacarpal joint of the base of the third metacarpal. Dislocation at the base of the fifth metacarpal was missed.

He was treated by reduction of the subluxation and immobilisation in plaster. There was, however, significant disability in terms of movement of the hand, wrist and forearm – due to persisting subluxation of the bases of the third and fifth metacarpals, and shortening of the fourth metacarpal.

Negligence alleged

While accepting that some of the difficulties could be attributed to the original injury, the patient claimed negligence by the hospital doctors.

Expert opinion

The MDU's orthopaedic expert commented:

"The X-rays... show a very severe injury to the right hand with carpo-metacarpal dislocations and a fracture of the fourth metacarpal. Later X-rays show persistence of the subluxation with premature fusion of the dislocated joints. The Statement of Claim alleges that this injury could only be treated by some form of internal fixature and that the conservative treatment employed was doomed to failure. Unfortunately, this is an absolutely correct interpretation..."

The MDU negotiated settlement for £80,000; this included a substantial component for loss of earnings and for the patient's much reduced ability to compete in the labour market.

This page was correct at publication on 01/01/2002. Any guidance is intended as general guidance for members only. If you are a member and need specific advice relating to your own circumstances, please contact one of our advisers.