Case Study: A Big Stretch!

A 60 year old gentleman developed severe pain in his right hip which was shown to be due to osteoarthritis.? He found it difficult to get about without a walking stick having previously enjoyed long country walks and hill climbing.

Pre-operatively, he was seen by his surgeon who stated he went over “all the risks of the procedure” and the patient signed a consent form which stated he had been told of the risks but did not list out what those were.

In the event, he had spinal anaesthesia for the surgery and initially both legs were numb and immobile.? However, his normal leg recovered well but on the operated side he developed a foot drop and some numbness.? He stated he had never been warned that this could happen.

The diagnosis was damage to his sciatic nerve which runs close to the hip joint.

Over 12 to 16 months his foot drop gradually improved and he was left with a small area of numbness on the latera aspect of his calf.

He complained that, although he had no pain from the hip following the surgery, he had been unable to resume his normal activities of walking and climbing because he was inclined to trip and had to use a toe strap and then an ankle brace for over one year.

Damage to the sciatic nerve is a potential complication of hip replacement.? It can be stretched during the process of dislocating and relocating the hip which is what appears to have happened in this instance.? It was not cut or damaged by diathermy (heat), and from an operative point of view there was therefore no evidence of any substandard care.

The only other event that can lead to temporary damage to the nerve is if the length of the hip prosthesis is too long, stretching the leg and therefore stretching the nerve from the back.? Measurements of the leg would demonstrate whether or not this occurred.? An increased leg length of more than 2cm is significant, and could lead to an action in negligence if remedial action was not immediately taken.

In this case there w,as no discrepancy in leg length and the nerve recovered.? An action in negligence would therefore be unlikely to succeed.

Initial screening is therefore essential to manage client expectations at an early stage. This avoids unnecessary effort and costs for all concerned. Too many cases are taken to Court with no chance of success. This is stressful for both the client and their legal advisor and indeed for the medical personnel involved.

For fast and effective screening of all potential medical negligence cases contact?

Peyton Medico Legal Services now on 028 87724177 or email [email protected]