£75,000 settlement for a missed scaphoid fracture at St Thomas’ Hospital

Josie Robinson

Josie Robinson, Senior Associate in the medical negligence team, acted for a client whose scaphoid fracture was missed at the Accident and Emergency Department of St Thomas’ Hospital, part of Guy’s and St Thomas’ NHS Foundation Trust. The 10-month delay in diagnosis turned what should have been a routine cast-and-recovery into grafting surgery, months of hand therapy, lost earnings and a change of career.

The claim settled for £75,000 after the Trust admitted liability in full.

What happened

Our client fell from his scooter in July 2022 and hurt his left wrist. A few days later he attended A&E at St Thomas’ Hospital. An x-ray was taken on the day. He was diagnosed with a sprained wrist and discharged without treatment.

The pain did not settle. He continued working as a cleaning supervisor in significant discomfort, struggling with the manual demands of his role and the reduced movement in his wrist. By January 2023 he was back at the Fracture Clinic at St Thomas’. This time the wrist was examined more carefully, a fresh x-ray showed a scaphoid fracture, and a follow-up scan confirmed the bone had failed to unite. Surgery was now needed to fix it.

Why a missed scaphoid fracture matters

The scaphoid is one of the small carpal bones in the wrist. It is essential for stability and movement, and it has a notoriously fragile blood supply. The most common mechanism for a scaphoid fracture is a fall onto an outstretched hand, exactly the kind of injury our client described.

A scaphoid fracture caught early can be treated conservatively in a back slab cast. Our client should have been in a cast and back to work in two to three months. Once the fracture is missed, the risks change. The fragment cut off from blood supply can develop avascular necrosis, where part of the bone dies. The fracture can then fail to unite, requiring bone grafting surgery and a long course of hand therapy. The long-term outcome can include reduced grip strength, chronic pain and limited wrist movement.

How the case was built

Expert evidence from an orthopaedic surgeon confirmed two things. First, that the clinical picture our client presented at A&E (a fall onto an outstretched hand, wrist pain, restricted movement) called for careful examination and proper imaging to exclude a scaphoid fracture, with MRI if x-ray was unclear. Second, that had the fracture been picked up at the first attendance, conservative treatment in a back slab would likely have allowed full recovery and a return to work within two to three months.

The Trust admitted liability in full for missing the fracture. The settlement reflected the consequences of the delay: pain and suffering from the unhealed fracture, the grafting surgery and hand therapy that would not have been needed with timely treatment, lost earnings, a period of depression, and the need to find alternative work in a less physically demanding role.

Expert commentary

Josie Robinson, who is a dual-qualified solicitor and a former physiotherapist specialising in musculoskeletal injuries, said:

“The scaphoid is a small bone in the wrist but is essential for stability and movement. The most common mechanism for the bone to fracture is a fall onto an outstretched hand, and the injury can be dismissed as a common wrist sprain if not properly examined.

My client presented at A&E with a history of a fall from his scooter, and any clinician should have had a high suspicion of a fracture, which should always be excluded with careful examination and appropriate imaging, either x-ray or MRI.

A missed scaphoid fracture is particularly vulnerable to avascular necrosis, where part of the bone dies due to a poor blood supply. This can lead to a non-union of the fracture, requiring complex grafting surgery and extensive physiotherapy. Unfortunately, the long-term outcome can be poor, with reduced function and chronic pain.”

Speak to a medical negligence solicitor about a missed fracture

If your fracture was missed at A&E or at a fracture clinic, and the delay caused additional surgery, lost earnings or long-term loss of function, our medical negligence solicitors can review your case in confidence and without obligation. We act on a no win no fee basis in misdiagnosis claims and orthopaedic negligence claims, including missed fractures and diagnostic errors at A&E.

Call 020 7485 8811 or fill in the contact form below.