I have recently settled two cases which involved significant awards for orthotics and prosthetics involving lower limb injuries suffered as a result of road traffic accidents. They offer a helpful reminder for practitioners and injured people not to overlook these claims which can be considerable.
The first case involved Ms K. A car ran over her right foot as she was crossing the road. The car was only going 5 mph but the driver was not looking. He let his vehicle come to a rest on Ms K’s foot and only removed it after hearing her screams.
Ms K suffered a fairly minor initial injury. She was x-rayed and diagnosed with an avulsion fracture of the first metatarsal bone. Her injuries were treated conservatively. She had to wear an aircast boot for 6 weeks and mobilise using crutches. She was unable to work for 2 months
Ms K then underwent physiotherapy treatment but when she was discharged her foot remained swollen and painful. She had difficulty fitting her right foot into her existing shoes because of the swelling.
I obtained funding from the motor insurers so that Ms K could be treated by a podiatrist who confirmed that she was suffering severe pain around the forefoot area. It was recommended that she was provided with custom-made orthotics to help stabilise her foot. The orthotics were made and immediately provided Ms K with significant pain relief. It was confirmed by her treating consultant that she would require orthotics for life.
Orthotics have a limited life span of around 18 months. It is also best practice to have regular assessments from an orthotist and fittings. In order to obtain clear evidence of the future costs, I obtained an expert report from a consultant orthotist. This confirmed the normal lifespan of a custom made orthotics and also confirmed that Ms K would need around 4 or 5 pairs so that she could fit them within a range of footwear. The expert advised that Ms K’s issues were so bad that he also recommended custom made footwear.
The expert’s recommendations were that Ms K would need custom-made orthotics and footwear for life. This amounted to a significant claim which could not have been anticipated initially given the nature of the injury.
The second case involved my client Ms L who suffered a traumatic amputation of her big, second and third toes as a result of a tipper truck driving over her foot as she crossed the road. Ms L underwent a series of operations before being discharged from hospital after 1 month.
Ms L was very stoical and returned to work within months. She received very little help with prosthetics on the NHS. She was only given a partial foot silicone which she could slip over the end of her foot. The silicone offered some cosmetic improvement but she could not fit it into any of her normal footwear. She could only use it on limited occasions such was when walking barefoot on the beach which meant it had limited use. Another issue for Ms L was that she was starting to suffer back pain as she was putting more strain on her back as a result of the loss of her toes.
The need for a prosthetics and orthotics expert was clear in this case and again added significant value. Unsurprisingly the expert recommended a completely new prosthesis costing more than £4000 which Ms L could use with normal footwear. The expert also recommended the provision of custom-made orthotics to alleviate pressure from her forefoot and to prevent pressure pain during weight bearing and this should help with her back pain. The orthotics needed to be replaced every 18 months and she would need annual appointments with an orthotist to make sure her needs would be managed.
Finally, the expert also recommended custom made footwear as it can be difficult to fit the orthotics into standard footwear. The costs over Ms L’s life amounted to more than £100,000.
These cases show the importance of considering orthotics and prosthetics in lower limb injuries.