What is a Scaphoid Fracture?
The scaphoid bone is a small but vital bone in the wrist, crucial for wrist function and movement. If injured, it can lead to significant and permanent damage, especially if the fracture is not diagnosed or treated in a timely manner. An x-ray and thorough clinical examination of the wrist are essential in diagnosing a scaphoid fracture. Typical initial treatment involves putting the wrist in plaster to for several weeks.
Scaphoid fractures can be difficult to diagnose initially after injury, even with an x-ray. If such a fracture is suspected then a follow-up appointment should be carried out in the next 2-3 weeks and the wrist should be put in plaster or a splint in the interim. The longer a scaphoid fracture is left without appropriate treatment the more likely the damage will be permanent and recovery will be prolonged, meaning that patients are suffering more pain that necessary. Should the scaphoid bone not heal, then surgical treatment may be necessary.
How to diagnose a fractured scaphoid?
Symptoms of a scaphoid fracture include pain, swelling and wrist stiffness and some patients may think that they have merely sprained their wrist. X-rays are usually helpful in diagnosing the fracture, but it is possible for a scaphoid fracture to be missed on the first x-ray.
Therefore, if a scaphoid fracture is suspected, a follow-up x-ray should be carried out 10 to 14 days later and the wrist should be immobilised with a splint on plaster in the meantime. A bone scan, CT scan or MRI scan can also be helpful in diagnosing the fracture.
Treatment of a scaphoid fracture
Typical treatment of a scaphoid fracture is to place the wrist in plaster for approximately 6 weeks. If this is unsuccessful or if the injury is not treated quickly enough at the outset, then further treatment is likely to be required which could include an operation to insert screws and a bone graft.
Please contact us for advice if you feel you may have a scaphoid fracture compensation claim, or have suffered any form of clinical negligence. Please note that there are strict time limits in place for making a claim for compensation, but our solicitors will be able to advise you specifically on the facts of your own case.
Case studies – scaphoid fractures
Our client attended A&E after injuring his right wrist playing football. His wrist was x-rayed and he was told that there wasn’t a bone injury so he must have ligament damage. Our client was given a splint and told to wear it during the day (not the night) for about 10 days and to take pain relief.
Our client continued to suffer from pain and stiffness in his wrist and so some 9 months later he went to his GP, who arranged for him to have an x-ray. The x-ray showed an old, unhealed fracture of the scaphoid bone. The hospital undertook further imaging which they believed demonstrated that the fracture was now healing and so our client was once again discharged from follow-up.
Over the following months, our client continued to suffer from pain and stiffness such that he was not able to carry out his job as normal.
Our client approached us to help him bring a claim against the hospital for the failure to diagnose his wrist fracture in the first place. As our client told us how much he was still struggling with his wrist (despite having been told the wrist had now healed), we arranged for him to have a private CT scan of his wrist. This was almost two years after his original injury and it showed that the scaphoid fracture had not healed. Not only that, but the damage was so severe that he needed an operation that included a bone graft and having a metal screw put in place to try and let the bone finally heal.
Although the operation was successful and much improved our client’s situation, he still suffered from some aching, pain and stiffness in his wrist. This meant that the movement in his wrist was restricted and he was unable to work at full capacity, undertake DIY tasks or enjoy his hobbies.
On our client’s claim against the hospital, the main allegations were that the defendant failed to diagnose and treat the scaphoid fracture when our client initially attended the Hospital and that the defendant then failed to recognise that the fracture had not healed when he attended some months later.
The defendant admitted some fault but would not accept that all of our client’s symptoms were as a result of their negligence. Our client’s claim settled in his favour and he received £75,000 compensation.
In 2008 our client sustained an injury to his right wrist whilst playing football. He attended his local walk-in centre the same day and was initially assessed by a nurse. The nurse thereafter referred him to the hospital for an x-ray. Our client returned to the walk-in centre with the x-ray he had taken at the hospital in order for it to be reviewed.
Our client was examined again and the x-ray was reviewed. The diagnosis of a wrist sprain was made and our client was given a future splint to wear during the day and advised to take painkillers. He was discharged without any follow-up.
Our client continued to suffer from symptoms of pain, stiffness and tenderness in his wrist. In 2009, he re-attended the walk in centre and was seen by a nurse who again diagnosed a sprain. Our client was given another wrist splint before being discharged without any follow-up.
Our client’s pain continued and he attended his GP, who referred him to a hospital for further x-rays of his wrist in 2010. The x-rays revealed that he was suffering from an old, ununited fracture of his right scaphoid bone.
Our client underwent screw fixation and bone graft of the right scaphoid. Further, x-rays were taken thereafter which showed that the fracture had unfortunately not united. Our client was given follow up x-rays four years after the injury and was informed that the fracture was still healing.
The injury and diagnosis affected our client’s life considerably as he was unable to pursue his chosen career in the army. Our client continued to suffer from pain in the wrist as well as reduced mobility and power.
We were instructed to act on behalf of the client by way of a clinical negligence claim. Following extensive initial investigations, which included a thorough review of our client’s medical records by our in-house doctor, we brought an action against the walk-in centre on his behalf. It was alleged that there was a failure to diagnose the scaphoid fracture which was visible on the initial x-ray and thereafter immobilise our client’s right wrist. As well as this, there was a failure to arrange further investigations and appropriate follow-up appointments thereafter. Our client would have avoided the prolonged pain, suffering and loss of amenity as well as avoiding the need for the screw surgery.
Liability was not admitted in full by the defendant’s solicitors and in particular, they disputed what difference earlier treatment would have made to our client’s outcome. However, they did make admissions in relation to the fracture being visible in the first x-ray and put forward a derisory offer in an attempt to settle.
We remained strong in our views that with earlier treatment our client would have avoided prolonged pain and suffering as well as the surgery to fit the screw into the scaphoid. We, therefore, proceeded to issue court proceedings against the defendant NHS Trust who provided the treatment at the walk-in centre.
We proceeded to obtain expert evidence from several specialists including a GP, Consultant Radiologist and Consultant Orthopaedic Surgeon. The evidence obtained supported our client’s claim in that the defendant breached their duty of care by failing to diagnose, treat and follow him up appropriately.
In an attempt to reach a settlement agreement prior to attending a hearing at court, considerable negotiations were entered and we were delighted to agree on a figure of £28,000 in full and final settlement of our client’s claim.
This settlement figure included a claim for general damages, past loss of earnings and care and assistance.
Can we help you?
Our team is headed by a dual qualified doctor and solicitor and we benefit from in-house medical knowledge. Our team of specialised medical negligence solicitors would be happy to help by quickly and efficiently assessing any areas of potential negligence for a wide range of claims.
Should you wish to have a free and confidential chat in relation to a potential scaphoid fracture claim, give our team of specialist clinical negligence solicitors a call on 01244 354688.