The wrist and hand are complex structures. The base of the wrist consists of the radius and ulnar. The radius is the large bone of the forearm, and the ulnar is the smaller bone that runs next to it on the pinky side. The base of the hand consists of small bones known as the carpal bones. They are held together with ligaments. The bones that make up the wrist have a smooth Teflon like surface. When these bones are in proper alignment the wrist can bend and move in a painless manner.
Surgery to the hand and wrist is complicated since it involves small bones in a crowded space. This is now often done using arthroscopic surgery. Small instruments, including a camera, are introduced through ports placed in the skin. The camera permits the surgeon to clearly see the operative field. Tiny drills, dissecting and cutting instruments are used for the surgery. Arthroscopic surgery reduces scar formation and healing time.
Hand surgery should be done by a hand surgeon, who is either an orthopedic surgeon or plastic surgeon with special training in hand surgery. Although there is no board certification for hand surgery, there is a certificate of added qualification for those who complete the special training.
Most of the hand/wrist surgery malpractice cases we have seen involved cutting the median nerve during carpal tunnel surgery. This is generally inexcusable. The median nerve is a large nerve which runs from the forearm through the wrist into the hand, and innervates the index, middle and ring fingers. Carpal tunnel surgery can be arthroscopic or open. Many surgeons prefer open surgery since the incision is not large, and the structures can be palpated. In open surgery the surgeon makes the incision along the palm of the hand and cuts the transverse carpal ligament. This relieves pressure on the median nerve. Special care must be taken not to cut the median nerve. The consequences of doing so could be devastating. The patient could permanently lose substantial function of the hand and suffer severe pain. When a nerve is cut a neuroma can form. A neuroma is bundle of cut nerve that is created when nerve attempts to regenerate. This can be very painful. Surgery may be needed to remove a painful neuroma. A surgeon should recognize when the nerve is cut. Early repair is more successful than if the repair is delayed.
One of our clients suffered total disability when her median nerve was cut. She suffered not only from loss of function of her dominant hand but chronic pain from neuroma formation. That case resulted in a settlement of $2,300,000.
Recently, we successfully tried a case where an orthopedic surgeon negligently performed wafer surgery. Wafer surgery involves the shaving of the ulnar head. Some people have ulnar bones which are too long. This may cause impaction with one or more carpal bones, which can lead to arthritis. By shortening the ulnar more space is created in the joint, which prevents impaction. The surgeon negligently shaved a section of the radial head, which is the base of the wrist, instead of shaving the adjoining ulnar head. This is a serious error since it results in post traumatic arthritis of the wrist. The client needed four wrist surgeries by a hand surgeon to deal with this problem. This caused severe complications, including complex regional pain syndrome, which rendered her disabled. The jury awarded a verdict in excess of $4,500,000.
Weisfuse & Weisfuse LLP represents victims of hand surgery malpractice. Call us at 212 983 3000 for a free consultation.