A guide to orthopaedic injuries

A serious injury can have a life changing and devastating impact on your life.

Claims for serious injuries should only ever be dealt with by specialist solicitors with the necessary qualifications and expertise to deal with the complex issues involved.

At Moore Barlow we specialise in cases involving the most serious and life changing types of orthopaedic injuries. We offer our clients a fully bespoke, personal service. Our highly qualified specialist solicitors have over 30 years of experience in dealing with claims concerning serious injuries. They will ensure not only that you receive appropriate compensation for your injury but that you receive the necessary rehabilitation and treatment you require.

We have in recent years been acknowledged as Personal Injury specialists in the leading directories to include The Legal 500 and Chambers. We are also recognised as a 1st tier Personal Injury firm.

We work all over the UK and we are happy to meet with you at your home, in hospital or an alternative place convenient to you. Over the years we have built up an extensive network of medical professionals to assist with assessing your requirements for care, rehabilitation, housing, aids, equipment, mobility and transport. We also work with the leading barristers in the field.

Our advice will help you to win the right compensation for your injuries and rehabilitation requirements.

Serious orthopaedic injury

Serious orthopaedic injuries can affect bones and joints in a way that they do not completely heal, meaning that you could be left with permanent long-term difficulties. Such an injury could result in you becoming reliant on others.

Serious orthopaedic injuries include:

  • Fractures: most serious orthopaedic injuries involve multiple bone fractures otherwise known as breaks. There are many types of serious fractures which are most commonly caused when there has been a severe trauma to the bone.
  • Ligament injuries: ligaments connect bones to other bones and form joints. The rigid nature of ligaments can cause them to tear and sometimes break if put under heavy stress from the impact of a trauma.
  • Muscle injuries: this occurs when groups of muscle fibres are torn. Serious muscle injuries can be debilitating as after a trauma your ability to use muscles effectively is restricted due to the pain. Often people will suffer with high levels of pain, inflammation and cramping.
  • Tendon injuries: commonly referred to as ruptures. A tendon may rupture as a result of a forceful impact. Once a tendon suffers a rupture it is not likely to regain the extent and efficiency of function it possessed before the trauma.

Orthopaedic injuries can also result in other complications including:

  • Complex regional pain syndrome
  • Neuropathic pain
  • Arthritis
  • Psychological symptoms

Orthopaedic injuries can have a life changing and devastating impact on your day to day life, you may lose your ability to carry out simple tasks, continue in your employment and in many circumstances you may not be able to live independently.

Those who have sustained orthopaedic injuries often face challenging times both financially and emotionally. This may extend to family and friends.

Treatment, care and rehabilitation

If you have sustained a serious orthopaedic injury you may require extensive rehabilitation, constant care and adaptations to your home. The aftermath of a serious orthopaedic injury and the recovery can be a long term, even life-long, process.

Over the years we have built solid relationships with medical professionals enabling us to ensure our clients receive all the treatment, care and rehabilitation they require without undue delay.

Orthopaedic injuries are treated in a number of ways, which fall largely into 4 areas:

  • Surgery: can be required in a number of instances from the repair of fractured bones or torn ligaments, to hip and knee replacements (arthroplasty) to key-hole surgery (arthroscopy).
  • Medication: since infection is a risk, and pain can also be excruciating, this treatment is likely to be combined with a course of medication. Once the initial healing process has taken place, the patient can begin the rehabilitation phase.
  • Physiotherapy: making key muscle groups stronger to increase ability and endurance. Physiotherapy can be frustrating, painful and tiring and it is important that the patient receives the right help and support.
  • Occupational therapy: supporting you through processes previously considered normal and every-day, such as bathing.

There are 3 stages of rehabilitation:

  • Acute stage: performing surgery and supporting you to do things you cannot. This is usually carried out in Intensive Care.
  • In-patient rehabilitation: can take place at hospital or in-patient centre, improving functionality, strength and mobility, finding new ways to accomplish daily tasks.
  • Out-patient rehabilitation: you live at home and have sessions at home or in rehabilitation centres. The aim is to maximise your ability to live independently.

It can be difficult for clients to move on from the incident which caused their injury and they can be haunted by memories for a long time. Meanwhile, their injuries might make social activities and other aspects of their former life impossible. This can lead to feelings of helplessness and isolation and should be monitored very closely by the people around them.

We can assist with arranging treatment for these symptoms. Treatment may include psychotherapy and this form of therapy will assist with reducing negative thinking during difficulty and emphasising positive thinking. Another form of therapy is Cognitive Behavioural Therapy (CBT) which aims to improve your thought processes and encourage a positive outlook for the future.


Amputation injury claim

Whether making a claim against an employer who has failed to safeguard your wellbeing, or against the driver of a motor vehicle, we have worked with a large number of clients who have pursued amputation claims.

Early rehabilitation in the aftermath of an amputation can have an extremely positive effect on a clients life and the compensation we win is essential in providing rehabilitation, ongoing treatment and care.

Between 5,000 and 6,000 major limb amputations are carried out in England every year. Many are carried out on people living with diabetes, since the condition causes nerve damage and as a result, a person is less aware of minor injury and wounds which can increase in severity. People living with diabetes are also more prone to suffering from PAD (Peripheral arterial disease).

Surgical amputation is a procedure carried out to remove an extremity, limb or part of a limb from the patient. It might be a finger, a toe, a foot, a hand or even an arm or leg. Typically, an amputation is carried out because of an injury, disease or infection.

Non surgical amputation, meanwhile, is the loss of an extremity or limb as a result of a serious injury or trauma (traumatic amputation). These injuries occur predominantly in manual workplaces, especially factories or sites which operate heavy machinery.

A complete amputation involves a complete break, where there are no tissues, ligaments, muscles or other anatomical structures connecting the amputated body part to the rest of the body. Incomplete or partial amputation involves a ligament, tendon or muscle which remains connected to the body.

When the amputation occurs close to the body’s core it is referred to as a proximal amputation. This includes amputations at the shoulder or hip. Distal amputations occur further from the core of the body. Things like fingers and toes can be lost. Distal amputations are more common than proximal amputations.

There are four predominant reasons that an amputation will take place:

  • A serious injury causes irreparable trauma to the limb
  • Peripheral arterial disease (PAD) causes gangrene, which in turn results in the loss of blood supply to part of the body
  • Another disease or infection, such as cancer, threatens the person’s health
  • Deformity, or persistent pain, limit the functionality of the limb

Complications arising from amputation include:

  • Heart attacks
  • Blood clots
  • Wound infections and slow healing
  • Pneumonia
  • Phantom limb pain
  • Other psychological problems

Accidents which result in amputation have life-long consequences, and the injured person isn’t the only person affected; their family and friends are involved too.

Recovery from an amputation is a complex process, which involves a large number of physical and mental requirements and challenges.

From the earliest moments spent in the hospital after surgery, to the return home and the readjustment to your day to day life, the process is an ordeal. Fortunately, most patients don’t have to go through it alone.

Once a patient has recovered from the anaesthetic, they may be placed on a catheter and left to focus on recovery with the help of strong painkillers.

When preparing to be discharged from hospital, you should be consulted by medical professionals, social workers, occupational therapists and physiotherapists. The latter will provide help and advice on exercises to reduce the risk of blood clots and circulatory problems.

A series of follow-up meetings will be scheduled for the period after you return home. Your progress and mental health will be monitored and you will be provided with the support you need.

You will also be granted access to amputee support groups in your area. Amputation care is as psychological as it is physical but there are key physical requirements.

If the circumstances are suitable, you may be fitted with a prosthetic limb. As a suitable candidate (one who is established as having the physical wellbeing to compensate for the loss of the limb) you will experience a number of exercises to prepare you to use the limb.

The skin around the stump first needs to be desensitised so that the prosthesis is comfortable to wear. This involves gently tapping the skin with a cloth, reducing swelling with compression bandages and preventing scar tissue by rubbing the skin around the bone.

There are a variety of prosthetic limbs available, which are generally categorised as lower limb or upper limb prostheses.

Lower-limb prostheses often contain:

  • Socket – the area which touches the limb
  • Suspension system
  • Artificial joint
  • Pylon – replicating the leg bone
  • Prosthetic foot

Upper limb prostheses often contain:

  • Socket
  • Suspension system
  • Control mechanism – designed to replicate movements of the arm and hand
  • Terminal device – replicating the hand, in function though not always in appearance

In addition to primary prostheses, there is a wide variety of Assistive Technology available to make everyday tasks a little simpler for the user. Electronically operated beds can help amputees up in the morning and voice activated computers can allow amputees to continue to operate their computer.

Mobility aids, like scooters, wheelchairs and walking sticks are frequently used. Homes and cars can be adapted in order to be used in spite of an amputation too, but all of these assistive technologies, home and vehicle adaptations require investment. That is why it is so important to get the compensation you deserve.

The right treatment, care and assistive technology will make a massive difference to your life but there is also a considerable sychological impact to think about.

Many people living with an amputation experience feelings of grief and bereavement in the same way they would a relative. There are three key aspects to the psychological impact of an amputation.

  • The loss of function of the amputated limb
  • The loss of sensation from the amputated limb
  • The negative body image and the perception from others

Negative thoughts are common following an amputation, particularly if the amputation was an accident or emergency and the amputee did not have time to prepare for the event.

The amputee can experience depression, anxiety, denial and might even feel suicidal.

Post traumatic stress disorder, (PTSD) is another factor and victims of traumatic amputation can relive their trauma and experiences other unpleasant symptoms.

It is important that you are given all of the support and help that you need.

Brachial plexus injury (BPI)

The brachial plexus is a complex system of nerves which start in the neck and branch out into the shoulders, arms and hands. They are responsible for controlling movement and feeling in the upper limbs.

When the brachial plexus is damaged this functionality can be significantly impaired.

Brachial plexus injury claims

The vast majority of paediatric and adult brachial plexus injury claims are caused by trauma and when this injury is caused by an incident which was not entirely the injured party’s fault, they are entitled to claim compensation.

Over the years, we have worked on a number of successful brachial plexus compensation claims and we understand how life altering these injuries can be; particularly since the causes of these injuries are often so traumatising to begin with.

  • High speed road traffic accidents, including car and motorcycle accidents
  • Blunt trauma and impact injuries
  • Stabbings and gunshot wounds
  • Inflammation, or brachial plexitis
  • Compression
  • Neuropathy

BPIs are further categorised by the type of harm they cause to the nerve network. The types of brachial plexus injury include:

  • Avulsion – the nerve is pulled out of the spinal cord with no chance of recovery
  • Rupture – the nerve is stretched, and at least partially torn, but not at the spinal cord
  • Neurapraxia – the nerve has been gently stretched or compressed but is still attached with a rapid recovery likely
  • Axonotemesis – the axons have been severed and recovery chances are moderate
  • Neurotemesis – the entire nerve has been divided and recovery chances are poor
  • Neuroma – A tumour has developed from a nerve which has been divided

There are a number of potential warning signs that a BPI has taken place, including:

  • Pain, including avulsion pain which feels like a burning or crushing sensation
  • Loss of sensation
  • Muscle weakness
  • Full or partial paralysis of shoulder or upper arm muscles

Predicting the recovery process of a brachial plexus injury is incredibly difficult, due to the complexity of the nervous system and the diverse nature of BPI cases.

A clients recovery will depend on the type of brachial plexus injury and the severity of it.

An accurate prognosis can only be provided if the client is assessed by a medical professional. Depending on the result of the assessment, a number of treatment, care and rehabilitation options may be available.

While some nerve injuries can correct themselves in time, others require significant intervention. Non surgical treatment, of course, is common even when surgery is not required. A course of rehabilitation is a form of non surgical treatment, which is always required to aid the recovery process and help the client, having sustained a nerve injury, to regain as much functionality and mobility as possible.

Surgical treatment for BPIs depends on the type and the severity. The primary types of brachial plexus surgery include:

  • Nerve graft – sections of nerve are harvested from elsewhere in the body and used to replaced damage nerve sections
  • Nerve transfer – replacing a nerve which is torn from the spinal cord with a less important nerve from elsewhere in the body
  • Muscle transfer – replacing a key arm muscle with a less important muscle or tendon from elsewhere in the body

While many BPIs can heal without lasting damage, some can cause long term, or life-long, complications, including:

  • Stiff joints – temporary paralysis can cause joints to stiffen
  • Pain
  • Loss of feeling – patients can burn or cut themselves without realising it
  • Muscle atrophy – lack of use during recovery can cause muscles to break down
  • Permanent disability

When an injury results in a lengthy recovery, or permanent disability, it can affect the clients ability to earn a living, but that isn’t all. The impact on their lifestyle can be substantial, even if an injury does not have lifelong consequences.

Permanent disabilities may leave the client in need of lifelong care and where they are able to regain some of their independence they may still rely on home adaptations, adapted cars and other mobility aids.

Improvements can occur slowly with BPIs and the recovery and rehabilitation process can take many years. In estimating recovery time, a number of factors have to be taken into account, including the severity of the injury and the nature of any surgery which was required.

Recovery chances are improved by courses of physical or occupational therapy. This kind of therapy can be essential when dealing with brachial plexus injuries as they will prevent the onset of muscle atrophy.

Clients are encouraged by medical professionals to perform exercises which engage the nerves and also allow muscles to function. Stretching is also important as it can improve range of motion and also increased the flow of blood to the injured area.

Helping you now and in the future

We will be with you every step of the way, throughout the legal process and beyond.

Our priority is to maximise your compensation award in the shortest time possible. However we are aware that money alone will not help with the new challenges you will face. Our aim is to enable you to achieve an independent and fulfilling life.

Many people who sustain a serious orthopaedic injury will require support for the rest of their lives. Our aim at Moore Barlow is to enable you to live as independently as possible. We have a wide range of contacts within organisations that can assist you.

These include:

  • Case managers who will assist and organise any support and care you may need
  • Support workers who will visit you on a regular basis to provide you with support and help
  • Community rehabilitation such as neuro physiotherapy and occupational therapy. We will help with the immediate issues you will face in the days and weeks after your accident, as well as assisting with any future legal or other requirements you may have.
  • Dealing with immediate and urgent financial issues
  • Speaking to your mortgage provider
  • Dealing with your employer
  • Checking your existing insurance policies
  • Advice regarding the involvement of the Court of Protection
  • Advice on funding your case

  • Interim payments
  • Equipment and aids
  • Rehabilitation
  • Education
  • Housing/housing adaptations
  • Investment of your compensation award
  • Periodic payments
  • Advice regarding disability discrimination
  • Holiday support
  • Other legal services including personal injury trusts, financial planning, wills advice and power of attorney

How much compensation will I receive?

If your claim is successful you will be awarded compensation. The aim of compensation is not only to compensate you for your injuries but to also put you in the same financial position you would have been if your accident had not occurred.

Our priority is to maximise your compensation award in the shortest time as possible time. However we are aware that money alone will not help with the new challenges you will face. Our aim is to enable you to achieve an independent and fulfilling life.

Compensation falls into two categories

The starting point for assessing the value of your injuries in monetary terms is medical evidence. We will arrange for an independent edical examination to be carried out by a specialist medico legal expert who will have access to your medical records and will see you with a view to providing a detailed report.

The type of expert you will see will depend upon the nature of your injuries. You may need to see several different experts. The report will document precisely what injury you have sustained and will provide details of any recommended treatment and/or recommendations for further examinations with other experts.

When the medical evidence is complete it will be possible to advise you as to the likely value of your claim for your injuries.

You are entitled to claim for any financial expenses that you have incurred as a result of the accident. These can include the following:

  • Loss of earnings
  • Future loss of earnings
  • Travel expenses incurred attending appointments at the hospital or GP surgery
  • Medical expenses
  • Care provided by a friend or family member on a gratuitous basis
  • Personal belongings and clothing damaged in the accident
  • The cost of aids and equipment
  • The cost of private medical treatment
  • Accommodation costs

These are just a few examples. When you start a claim for personal injury it is a good idea to keep hold of any receipts or invoices for items purchased as a result of your injuries.

It is also a good idea to keep a diary with details of any care provided by a friend or family member.

Legal costs

Many clients have concerns about how their claim will be funded. At the outset of your claim we will discuss the various methods of funding with you and agree a method of funding that does not expose you to any financial risk or worry.

There are a number of alternatives available to you and we can advise you as to which would be the best option to fund your claim.

  • Conditional Fee Agreements (CFAs): You may have heard of these referred to as “No Win, No Fee” agreements, and they are used to fund the majority of personal injury claims. If we are successful on your behalf, the majority of your costs will be paid for by our opponents. If your claim is unsuccessful, you will not be charged for anything.
  • Legal Expenses Insurance: You may have legal expenses insurance attached to your home and contents insurance or another type of insurance policy. The policy may provide cover to enable you to pursue a claim for personal injury. We will be happy to check your insurance policies for you to see whether you have suitable legal expenses insurance.
  • Privately Paying: If we feel unable to offer a CFA on day one as the merits of your case are unclear, we may offer a privately paying arrangement to include a fixed fee retainer. This will be limited to carrying out an initial investigation before offering you an alternative method of funding. In the vast majority of cases we are happy to offer a CFA from the outset.
  • Trade Union: Trade Union members can in some instances obtain help with legal costs.

When should I contact a solicitor?

You or a family member should contact us as soon as possible. We can guide you through the initial process and provide you with advice as to whether you have a claim. It is important that you contact an experienced specialist solicitor to receive the best legal advice.

Our immediate aim will be to arrange rehabilitation for you and to start work on the initial stages of your case. In addition we can advise you on your benefit rights, liaise with the police to keep you up to date with any criminal prosecutions arising from the incident and also advise you on dealing with debts that may arise due to being off work.

If you are unsure whether you have a claim or you are unsure whether the incident was your fault, or partly your fault, then contact us and one of our expert solicitors will be happy to discuss your case with you. Even if you have been told by another firm of solicitors that you do not have a claim, we would be happy to give you a second opinion free of charge.

If you have already appointed another solicitor but are not happy with the level of service that you are being provided, the way your case is being handled or the amount of compensation that has been obtained on your behalf, please contact our expert team today.

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