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Hand injuries: a rising concern within clinical negligence

We get a lot of enquiries regarding inadequate treatment at A&E with regards to hand injuries and we are currently involved in several cases where the claimant has been left with permanent damage as a result of inadequate history being taken from the patient/claimant and/or inadequate examinations.

We appreciate our A&E teams are being stretched to the limit and the difficulties they face are regularly in the news, however, a recent study found the management of hand trauma is generally poor within the ‘urgent care’ setting and capsule, tendon, nerve and joint injuries are often missed. To ensure that substandard care is prevented in the future, clinicians and healthcare providers need to ensure the following:

1. There is sufficient middle-grade supervision in A&E 24/7 for associated Urgent Care Centre’s to seek advice from.

2. On call, FY2s should not be giving telephone advice and should be physically present to examine the patient.

3. Wounds to the hand over a joint should always be cleaned and irrigated and antibiotics administered, especially if the wound is old and/or an open fracture is diagnosed.

4. Open or old wounds should not be closed with glue, even if preferred by the patient given the risk of infection. Stitches are the most appropriate way to close a wound of this type but only by an experienced clinician.

5. Awareness should be given to the fact that the longer you leave an open wound, the higher the chance of infection. Dirty and contaminated wounds do better when treated early.

6. Lacerations to the flexor surface of the hand should always be examined by an experienced doctor. A tendon and nerve injury should always be assumed until proven otherwise. Partial tendon injuries are easily missed.

It is important to bear the above in mind if you have been treated recently and feel you may have been rushed or inadequately examined.

If you are concerned and have recently been advised that you require further treatment due to a delayed or missed diagnosis call our team to find out how we can assist you with your compensation claim.

You can contact us by calling 0800 1979 345 or alternatively you can complete our online enquiry form.