What is orthopaedic negligence?
Orthopaedic negligence is clinical negligence in the specialty of orthopaedic surgery and trauma — covering bone, joint, muscle, tendon, ligament, and spinal conditions. As with all clinical negligence, the question is whether the clinician's care fell below the standard of a reasonably competent orthopaedic surgeon, and whether that failure caused harm.
Common types of orthopaedic negligence claim
Hip and knee replacement negligence
Hip and knee joint replacement surgery is one of the most common orthopaedic procedures. Claims include: wrong-size implant causing instability or pain; failure to detect and treat post-operative infection leading to implant failure or revision surgery; compartment syndrome after knee replacement; nerve damage from poor positioning or surgical technique; and failure to obtain adequate consent for the risks.
Fracture misdiagnosis
Fractures that are missed on initial imaging — particularly scaphoid fractures, stress fractures, and children's fractures — are a common source of claims. The standard requires that a radiograph is properly reported and that clinical assessment takes account of mechanism of injury and tenderness patterns even when initial imaging is equivocal.
Spinal surgery negligence
Complications of spinal surgery — nerve root damage, cord injury, infection, implant failure — can occur even with properly performed surgery. Claims succeed where the surgical technique fell below the required standard, where the wrong level was operated on, or where post-operative neurological deterioration was not investigated and treated in time.
Compartment syndrome misdiagnosis
Compartment syndrome — dangerously elevated pressure within a muscle compartment following injury — is a surgical emergency requiring urgent fasciotomy. Missed or delayed diagnosis causes muscle necrosis, permanent contracture, and sometimes limb loss.
Delay in fracture fixation
Where a fracture requires operative fixation and the delay in surgery allows the fracture to displace or the patient to develop complications (fat embolism, pressure sores in the elderly), a claim may arise.
Negligent management of open fractures
Open fractures require urgent debridement and antibiotics to prevent osteomyelitis. Failure to treat promptly or adequately can cause chronic bone infection and permanent disability.
Fractures most commonly missed on X-ray
- Scaphoid fracture — may not be visible on initial X-ray; requires clinical suspicion and CT or MRI
- Stress fracture — not visible on plain X-ray; requires bone scan or MRI
- Tibial plateau fracture — subtle on initial views; requires CT
- Odontoid (C2) fracture — easily missed in the elderly; requires CT cervical spine
- Undisplaced hip fracture — may not be visible on plain X-ray in the elderly; requires MRI
- Children's fractures — growth plates misidentified; incomplete (greenstick) fractures missed
What do you need to prove?
The standard four elements apply. An independent orthopaedic expert will assess whether the surgical technique, the imaging interpretation, or the post-operative management fell below the standard of a reasonably competent orthopaedic surgeon.
Frequently asked questions
Can I claim if a fracture was missed on X-ray?
Yes — if a competent radiologist or emergency medicine clinician would have identified the fracture from the imaging available. For scaphoid fractures, a claim may also arise from failure to arrange CT or MRI when clinical signs pointed to the fracture despite a normal X-ray.
Can I claim if my hip replacement failed and I needed revision surgery?
Yes — if the failure was caused by a surgical error rather than a normal implant complication. The claim requires expert evidence that the failure resulted from a technique below the required standard.
What is compartment syndrome and when is delayed diagnosis negligent?
Compartment syndrome is a surgical emergency. Delayed diagnosis and fasciotomy is negligent when the clinical signs — pain out of proportion to injury, pain on passive stretch, paraesthesia, pallor — were present and not acted upon.
Related guides
- Surgical negligence claims
- Cauda equina negligence claims
- Hip replacement negligence claims
- Nerve injury compensation claims
Sources & further reading
Primary statute, case law and regulator guidance referenced in this article.