The plaintiff alleged that Feldman, Kleidman, Collins & Sappe LLP’s (FKC&S) orthopedist client negligently performed an open reduction with internal fixation (ORIF) on a dislocated, tri-malleolar ankle fracture on November 25, 2020. Furthermore, the plaintiff alleged that the orthopedist improperly placed the surgical hardware on the lateral side of her ankle and then failed to remove the hardware in a timely fashion. She contended that the hardware caused damage to the ankle which then required further surgery in January of 2023 and left her with ongoing disability. The additional surgery consisted of hardware removal, fusion of the subtalar joint, a tarsal tunnel release and removal of a bone fragment on the medial side of the ankle with medial ligament repair.
The plaintiff further alleged that she requested that FKC&S’s client remove the hardware during her follow-up visits, and he failed to do so, thus prolonging her pain and suffering.
Robert R. Sappe demonstrated to the court that the orthopedist’s care was appropriate, the hardware was properly placed during the ORIF and the fracture healed. Removal of hardware after the fracture heals requires a judgment call based on the benefits and risk of removal. Here, the orthopedist felt that the plaintiff’s ongoing complaints were primarily due to other pre-existing conditions in her foot such as subtalar arthritis. The subtalar arthritis was in a joint below the level of the fracture and was not impacted by the hardware. During follow up office visits, the orthopedist had recommended conservative measures to address the subtalar arthritis such as bracing of the foot. The orthopedist told the plaintiff that, in his opinion, removal of the hardware would likely not relieve her complaints of pain.
Sappe successfully demonstrated to the court that, except for the subsequent removal of the hardware, all the other aspects of the January 2023 surgery were unrelated to the ORIF done in 2020. The 2023 surgery addressed conditions which were on the medial side of the ankle and in the subtalar joint, which were not near the laterally placed hardware. The subtalar fusion was necessitated by pre-existing subtalar arthritis; the removal of the medial bone fragment involved a piece of bone on the opposite side of the ankle which either did not heal or subsequently developed from the trauma of the fracture-dislocation; the repair of the medial ligament was on the opposite side of the ankle from the hardware and was necessitated by the bone fragment removal; and the tarsal tunnel release was a nerve issue which developed on the side of the ankle opposite from the hardware.
Sappe further pointed out that the hardware was removed during the 2023 surgery only as an incidental measure, meaning that the surgeons removed it because they were already performing other procedures on the foot and the hardware had served its purpose of successfully supporting the severe fracture to heal. Finally, he demonstrated to the court that the plaintiff’s ongoing complaints of disability were either unrelated to the ORIF procedure or due to the severe nature of the initial fracture-dislocation.
The court dismissed all the plaintiff’s claims, finding them to be without merit.