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Case Study: Missed Elbow Fracture Leads to Delayed Surgery
Mandy, 11 years old, Staffordshire
Mandy was performing gymnastics with she fell onto her left arm (she was right handed). She heard a crack when she fell and was sure she had broken it. Her parents took her to A&E where an X-ray was taken. The doctor could not identify any bone injury so she was send home with a collar and cuff to be reviewed 3 days later in the fracture clinic. She was not told to fully immobilise the arm.
When she attended the clinic the X-ray had been reviewed by a radiologist and the correct diagnosis of a fractured elbow (transverse supracondylar fracture) was made. This type of fracture requires surgery so she was booked in immediately.
The operation to insert screws to fix the fracture could not take place as planned because the arm was by now very swollen so the surgery was postponed for a couple of days.
When Mandy was reviewed after a few weeks doctors found one of the screws used to fix the fracture was protruding through the skin. Mandy needed a second surgery to remove the screws.
Long term effects
Mandy’s elbow remained very stiff for some time and she was limited in moving the arm.
Mandy’s mother felt that the elbow fracture should have been diagnosed when she first seen in A&E. She felt that if the correct diagnosis had been made the surgery would have taken place urgently and Mandy would have avoided five extra days of pain and suffering. It was also suggested that Mandy may have had a better outcome. Although an expert did not agree that Mandy’s arm would have had better function (as the outcome was due to the injury rather than a delay) it was agreed that the fracture should have been picked up in A+E.
Mandy received £1,100 compensation from the Hospital.
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