Behandlungsfehlervorwürfe nach distalen Radiusfrakturen

Zusammenfassung

Hintergrund: Die Vielseitigkeit der distalen Radiusfrakturen, der Diagnostik- und Therapiemöglichkeiten birgt großes Potenzial für eine mangelhafte Genesung mit der Folge der Patientenunzufriedenheit. Das Ziel dieser Studie ist die Evaluierung distaler Radiusfrakturen, die sekundär zu juristischen Streitfällen führten, um Rückschlüsse für Optimierungs-. bzw. Präventionsmaßnahmen zur Steigerung der Patientenzufriedenheit und Vermeidung von Folgekosten zu ziehen

Material und Methoden: Akten und Patientendaten aller juristisch behandelter Streitfälle in Bezug auf distale Radiusfrakturen eines öffentlichen Krankenhausbetreibers wurden im Zeitraum 2007 bis 2017 eingesehen und einer deskriptiven Statistik unterzogen.

Ergebnisse: Insgesamt wurden 35 Fälle mit Beschwerden in Bezug auf Behandlungs-, Kommunikations- und Folgeschäden identifiziert, die durch die deskriptive Statistik weiter analysiert und nach Schwerpunktthemen weiter aufgeschlüsselt wurden.

Schlussfolgerung: Komplikationen und Spätfolgen bei distaler Radiusfraktur sind nicht gänzlich vermeidbar, Kommunikationsdefizite und Behandlungsverzögerungen jedoch weitestgehend schon. Eine Reflexion der diagnostischen und therapeutischen, aber insbesondere der interpersonellen Herangehensweise erscheint im Sinne einer gesteigerten Patientenzufriedenheit unabdingbar.

Abstract

Background: As distal radius fractures as well as diagnostic and therapeutic options vary widely, there is an enormous potential for deficient convalescence and subsequent patient dissatisfaction. The aim of this study is the evaluation of malpractice in distal radius fracture management, which could help to draw conclusions regarding optimization and prevention as well as raising patient satisfaction and minimizing subsequent costs.

Material and methods: Files and patient data of all distal radius fracture complaints regarding one public hospital operator in a period between 2007 and 2017 were reviewed and subjected to descriptive statistics.

Results: A total of 35 cases with complaints regarding medical treatment, communication and long-term effects were identified, broken down into key issues and analyzed by means of descriptive statistics.

Conclusion: Complications and long-term effects of distal radius fractures are not completely avoidable. It is possible, however, to prevent lack of communication and treatment delays. To achieve increased patient satisfaction, it is essential to reflect on diagnostic, therapeutic and interpersonal strategies.

Schlüsselwörter

distale Radiusfraktur - Patientenzufriedenheit - Rechtsstreit

Key words

distal radius fracture - patient satisfaction - disputes

Publication History

Received: 26 July 2020

Accepted: 06 December 2021

Article published online:
15 February 2022

• Literatur

• 1 Unglaub F, Langer MF, Hohendorff B. et al. Distale Radiusfraktur. Orthopade 2017; 46: 93-110 DOI: 10.1007/s00132-016-3347-5.
• 2 Mosenthal WP, Boyajian HH, Ham SA. et al. Treatment Trends, Complications, and Effects of Comorbidities on Distal Radius Fractures. HAND 2019; 14: 534-539 DOI: 10.1177/1558944717751194.
• 3 Lutz K, Yeoh KM, MacDermid JC. et al. Complications associated with operative versus nonsurgical treatment of distal radius fractures in patients aged 65 years and older. J Hand Surg Am 2014; 39: 1280-1286 DOI: 10.1016/j.jhsa.2014.04.018.
• 4 Sandelin H, Waris E, Hirvensalo E. et al. Patient injury claims involving fractures of the distal radius. Acta Orthop 2018; 89: 240-245 DOI: 10.1080/17453674.2018.1427966.
• 5 Ring J, Talbot CL, Clough TM. Clinical negligence in foot and ankle surgery: A 17-year review of claims to the NHS Litigation Authority. Bone Joint J 2014; 96-B: 1510-1514 DOI: 10.1302/0301–620X.96B11.33963.
• 6 Brown TW, McCarthy ML, Kelen GD. et al. An Epidemiologic Study of Closed Emergency Department Malpractice Claims in a National Database of Physician Malpractice Insurers. Acad Emerg Med 2010; 17: 553-560 DOI: 10.1111/j.1553-2712.2010.00729.x.
• 7 Singh H, Graber ML. Improving Diagnosis in Health Care – The Next Imperative for Patient Safety. N Engl J Med 2015; 373: 2493-2495 DOI: 10.1056/NEJMp1512241.
• 8 Mahdavian Delavary B, Cremers JEL, Ritt MJPF. Hand and wrist malpractice claims in The Netherlands: 1993–2008. J Hand Surg Eur Vol 2010; 35: 381-384 DOI: 10.1177/1753193409355735.
• 9 Jakubietz MG, Gruenert JG, Jakubietz RG. Palmar and dorsal fixed-angle plates in AO C-type fractures of the distal radius: is there an advantage of palmar plates in the long term?. J Orthop Surg Res 2012; 7: 8 DOI: 10.1186/1749-799X-7-8.
• 10 Roth KM, Blazar PE, Earp BE. et al. Incidence of Extensor Pollicis Longus Tendon Rupture After Nondisplaced Distal Radius Fractures. J Hand Surg Am 2012; 37: 942-947 DOI: 10.1016/j.jhsa.2012.02.006.
• 11 Al-Rashid M, Theivendran K, Craigen MAC. Delayed ruptures of the extensor tendon secondary to the use of volar locking compression plates for distal radial fractures. J Bone Joint Surg 2006; 88: 1610-1612 DOI: 10.1302/0301-620X.88B12.17696.
• 12 Limthongthang R, Bachoura A, Jacoby SM. et al. Distal radius volar locking plate design and associated vulnerability of the flexor pollicis longus. J Hand Surg Am 2014; 39: 852-860 DOI: 10.1016/j.jhsa.2014.01.038.
• 13 Quadlbauer S, Pezzei C, Jurkowitsch J. et al. Early complications and radiological outcome after distal radius fractures stabilized by volar angular stable locking plate. Arch Orthop Trauma Surg 2018; 138: 1773-1782 DOI: 10.1007/s00402-018-3051-5.
• 14 Foo T-L, Gan AW, Soh T. et al. Mechanical Failure of the Distal Radius Volar Locking Plate. J Orthop Surg 2013; 21: 332-336 DOI: 10.1177/230949901302100314.
• 15 Esenwein P, Sonderegger J, Gruenert J. et al. Complications following palmar plate fixation of distal radius fractures: a review of 665 cases. Arch Orthop Trauma Surg 2013; 133: 1155-1162 DOI: 10.1007/s00402-013-1766-x.
• 16 Özbek Ayanoğlu T, Armangil M. How effective is skyline view for avoiding dorsal cortex penetration in volar plate fixation of intraarticular and dorsal cortex comminuted distal radius fractures. Injury 2019; 50: 1684-1688 DOI: 10.1016/j.injury.2019.07.018.
• 17 Riddick AP, Hickey B, White SP. Accurancy of the skyline view for detecting dorsal cortical penetration during volar sital radius fixation. J Hand Surg Eur Vol 2012; 37: 407-11 DOI: 10.1177/1753193411426809.
• 18 Prommersberger K-J, van Schoonhoven J. Korrektureingriffe nach distaler Radiusfraktur. Unfallchirurg 2007; 110: 617-630 DOI: 10.1007/s00113-007-1293-8.
• 19 Millett PJ, Rushton N, Millet PJ. Early mobilization in the treatment of Colles’ fracture: a 3 year prospective study. Injury 1995; 26: 671-675 DOI: 10.1016/0020-1383(95)00146-8.
• 20 Warwick D, Field J, Prothero D. et al. Function ten years after Colles’ fracture. Clin Orthop Relat Res 1993; 295: 270-274 PMID: 8403660
• 21 Patel VP, Paksima N. Complications of distal radius fracture fixation. Bull NYU Hosp Jt Dis 2010; 68: 112-118
• 22 DeNoble PH, Marshall AC, Barron OA. et al. Malpractice in Distal Radius Fracture Management: An Analysis of Closed Claims. J Hand Surg Am 2014; 39: 1480-1488 DOI: 10.1016/j.jhsa.2014.02.019.
• 23 King JD, van Dijk PAD, Overbeek CL. et al. Patient Complaints Emphasize Non-Technical Aspects of Care at a Tertiary Referral Hospital. Arch Bone Jt Surg 2017; 5: 74-81 PMID: 28497096
• 24 McKay SD, MacDermid JC, Roth JH. et al. Assessment of complications of distal radius fractures and development of a complication checklist. J Hand Surg Am 2001; 26: 916-922 DOI: 10.1053/jhsu.2001.26662.
• 25 Ahmad R, Shobaki S, Etezadi V. et al. Adequacy of consent in patients with distal radius fractures. Int Orthop 2009; 33: 1311-1313 DOI: 10.1007/s00264-009-0767-4.
• 26 Das Arzt-Patienten-Verhältnis im 21. Jahrhundert – Ärztekammer Nordrhein. Im Internet: https://www.aekno.de/wissenswertes/dokumentenarchiv/dokumentation/das-arzt-patienten-verhaeltnis-im-21-jahrhundert (Stand: 25.01.2021)