Limb lengthening and reconstruction orthopaedic surgeries: When medical negligence may arise

Limb lengthening and reconstruction surgeries are advanced orthopaedic procedures used to treat various conditions such as congenital limb discrepancies, traumatic injuries, and deformities caused by infection or bone cancer. These surgeries can significantly improve a patient’s quality of life by restoring mobility, alleviating pain, and improving limb function.

However, the complex nature of these procedures means that, when something goes wrong, the consequences can be severe. If medical professionals fail to follow appropriate clinical guidelines or provide substandard care, patients may be entitled to bring a medical negligence claim.

What is limb lengthening and limb reconstruction?

 Limb lengthening is a surgical process used to gradually increase the length of a bone, typically using an external fixator or an internal lengthening device. This may be necessary for patients with:

  • Congenital limb length discrepancies
  • Traumatic injuries
  • Amputations requiring limb equalisation

The process occurs over several months and is usually carried out in carefully planned stages.

Limb reconstruction on the other hand, refers to procedures designed to restore the structure and function of a limb following injury, disease, or deformity. Reconstruction techniques may include:

  • Bone grafting
  • Osteotomy (bone realignment)
  • Use of implants or prosthetics

Any procedure requires meticulous surgical technique, thorough planning and comprehensive postoperative care. Failure at any stage could give rise to complications and in some cases  to claims for orthopaedic negligence.

When can medical negligence occur?

Healthcare professionals owe their patients a legal duty of care. They must provide treatment that meets the standard of a reasonably competent practitioner in their field. Negligence occurs when this duty is breached and the breach causes avoidable harm.

To be successful, a medical negligence claim must satisfy two legal tests:

 

  1. Breach of Duty

It must be shown that the care provided fell below the standard expected of a reasonably competent professional in that specialism. A claim will usually fail if the healthcare provider can demonstrate that a responsible body of clinicians would have acted similarly.

 

  1. Causation

 

It must then be proven that, on the balance of probabilities (i.e. more than a 50% chance), the injury or poor outcome would have been avoided had the proper standard of care been met.

Common examples of negligence in limb lengthening and reconstruction

 

Surgical errors

 

These procedures require extreme precision. Common errors include:

 

  • Incorrect placement of external or internal fixation devices, causing malalignment or deformity
  • Poor surgical technique resulting in abnormal bone growth or failure to achieve intended length
  • Damage to nerves, blood vessels, or surrounding tissue during surgery

 

Inadequate preoperative assessment and consent

 

A full preoperative assessment is crucial to identify any risks or contraindications. Failures may include:

 

  • Incomplete imaging or assessment of bone and soft tissue
  • Failure to identify underlying conditions affecting healing
  • Inadequate consent procedures, particularly in paediatric cases  where risks are not clearly explained

 

Poor postoperative monitoring

 

Post-surgical care is just as important as the surgery itself. Failures here can include:

 

  • Not recognising signs of infection, non-union, or delayed healing
  • Lack of follow-up imaging or clinical reviews
  • Insufficient rehabilitation advice, impacting mobility and recovery

 

Improper use or management of medical devices

 

Limb lengthening devices must be managed correctly throughout treatment. Negligence may occur where:

 

  • Devices are improperly adjusted or maintained
  • There is a failure to act when a device is malfunctioning
  • Infection or bone damage occurs due to poor hygiene or delayed treatment

 

We’re here to help

 At Tees, we offer a Conditional Fee Agreement (No Win, No Fee). This allows you to pursue a claim without financial risk. If the claim is unsuccessful, you won’t be liable for legal fees (provided you have complied with your obligations). If your case succeeds, most legal costs are recovered from the Defendant, with only a small contribution payable from your compensation.

Our specialist medical negligence lawyers have experience dealing with complex orthopaedic claims, including cases involving limb lengthening and reconstruction surgery. We are here to guide you through the process and offer clear, practical advice.

To discuss your situation confidentially or determine whether you may have a claim, please get in touch with Sophie Stuart in our team today.

Surgeon Yaser Jabbar: Patient ‘G’s case of Medical Negligence

This is the story of Patient ‘G’, a teenager whose life has been severely impacted by the substandard care and questionable practices of surgeon Mr Yaser Jabbar, who worked at the renowned Great Ormond Street Hospital (GOSH) in London.

The harrowing experience of Patient ‘G’ sheds light on the systemic failures that allowed such negligent care to persist, and the fight for justice and accountability.

Yaser Jabbar’s troubled tenure at GOSH

Mr Yaser Jabbar, a 43-year-old surgeon, joined the orthopaedic department at GOSH in June 2017, quickly making a name for himself as a specialist in complex leg-straightening and lengthening procedures.  Dubbed the “frame guy” by his colleagues, Jabbar became known for his work with children suffering from congenital limb deformities.

However, beneath the surface, concerns about Mr Jabbar’s practice began to emerge. Colleagues raised concerns about his “cavalier” approach to unexpected complications and his tendency to dismiss or even hide these issues, raising serious questions about patient safety under his care.

The troubling case of Patient ‘G’

Patient ‘G’ was born with VACTERL association, a genetic condition that affects the formation of the bones and organs in utero. He suffers from a radial club hand deformity with thumb hypoplasia, which affects the bones of his hand, radius and ulna. They were referred to GOSH in February 2017 at the age of nine, to explore surgical options to straighten and lengthen his left arm and wrist, with the hopes of improving the cosmetic appearance.

‘G’ was initially seen by Mr Jabbar in January 2020 and later again in February 2020 and April 2021.  Unfortunately, these appointments were marked by a lack of detailed medical history-taking or clear communication about the proposed surgical plan and its risks and benefits.

The flawed surgery

In June 2021, ‘G’ underwent surgery to his left arm – but what was performed was vastly different from what had originally been planned. Instead of the agreed-upon procedure to “straighten and lengthen” the left forearm with an Ilizarov frame, Mr Jabbar performed a “length neutral (or even shortening) correction with a plate, and joint distraction. This approach was later deemed “unacceptable” following an investigation by the Royal College of Surgeons (RCS) into Mr Jabbar’s practice.

The RCS report criticised Mr Jabbar’s surgical technique, noting significant under-correction of the radial inclination and the lack of a clear plan for follow-up procedures.  His choices were considered highly questionable.

Complications and consequences

Following the surgery, ‘G’ faced a series of complications, including persistent pain, nerve issues and worsening deformity. ‘G’ also developed a post-operative infection, which required removal of the metal pins in his arm. These problems required multiple additional surgeries and extended treatment, including bone grafting.

The RCS investigation concluded that ‘G’ had suffered “moderate harm” due to Mr Jabbar’s actions, with the possibility of further deterioration and the need for more corrective procedures in the future. The findings also noted that Mr Jabbar failed to properly inform ‘G’ and their family about the significant changes made to the surgical plan – raising further concerns about professionalism, transparency and patient care.

The devastating impact

The consequences of Mr Jabbar’s actions have been far-reaching and deeply damaging for Patient ‘G’. Their left arm, which had previously undergone successful surgical correction at a young age, was now in a worse condition, with increased deformity, reduced function, and ongoing pain. Three years on, ‘G’ is still awaiting treatment to rectify the damage caused by Mr Jabbar.  The experiences have taken a significant toll on their physical and emotional wellbeing.

Wider systemic failures at GOSH

Unfortunately, this case is not an isolated incident, but part of a larger pattern of systemic issues within GOSH’s orthopaedic department. The RCS investigation revealed a “dysfunctional” team environment, marked by poor communication, a lack of collaboration, and hostility towards staff members who raised concerns.  The report also highlighted failures in the hospital’s leadership which ignored or downplayed warnings from staff, allowing Mr Jabbar’s harmful practices to go unchecked for years, ultimately leading to the harm of hundreds of young and vulnerable patients.

The aftermath and ongoing legal battle

In the wake of the RCS investigation, GOSH has launched a comprehensive review of the cases of 721 children treated by Mr Jabbar, with the hospital acknowledging the “serious concerns” raised and apologising to the affected families.

Georgina Wade, Solicitor at Tees is representing ‘G’ and his family in the pursuit of justice for the harm caused by Mr Jabbar’s negligence. Georgina is also representing a number of other families who have been affected.

The case of Patient ‘G’ and the broader issues at GOSH highlight the critical need for accountability and transparency within the medical profession. When there is a breakdown of trust, and patient safety is compromised, the consequences can be devastating – not only for the individuals and families directly affected, but also for the public’s confidence in the healthcare system.

The call for accountability and reform

This case is one of several cases which serves as a call to action – healthcare providers must prioritise patient safety, foster a culture of openness, and swiftly address shortfalls in care when they occur. Only by committing to these values, can we protect vulnerable patients like ‘G’ and begin to rebuild and restore trust in the medical profession.

Statement from solicitor Georgina Wade

Solicitor Georgina Wade said: “As the family’s solicitor I am deeply troubled by the findings of the Royal College of Surgeons into the care provided to ‘G’ by Mr Jabbar. Both ‘G’ and his family trusted him; he was someone they believed to be a respected and experienced surgeon at one of the world’s leading children’s hospitals. He abused that trust and used his position of authority to perform a totally different surgical procedure to the one which was agreed to by ‘G’ and his family.

“Beyond Mr Jabbar’s worrying practices, the fact that he was allowed to continue treating children after concerns were raised about his practice also raises questions about the conduct of Great Ormond Street. As the extent of Mr Jabbar’s worrying practices now comes to light, I am shocked to see how many vulnerable children have been affected by his behaviour. One child coming to harm is one too many. ‘G’ and his family, along with all those affected by this deserve answers and accountability, as they will have to live with the consequences of the actions of both GOSH and Mr Jabbar for the rest of their lives.”

 

£750,000 settlement after negligent knee replacement surgery

Tees secured a £750,000 settlement for a client whose knee replacement surgery was performed negligently.

The incident

Our client [E] underwent total knee replacement (TKR) surgery in March 2011. Unfortunately, a surgical error resulted in his knee and foot becoming misaligned. As a result of the surgery, E could turn his right foot 180 degrees so that it pointed directly behind him.

To correct the malrotation, E went through two painful revision knee replacement operations. He now suffers from chronic pain in his back and leg, and cannot walk long distances. The pain left him unable to work, forcing him to retire from a much-loved career operating military drones.

Seeking legal support

E contacted Tees Law about making a claim against the NHS Trust responsible for his knee surgery. Our expert team of Medical Negligence solicitors took his case on a ‘no win, no fee’ basis.

Building the case

Between 2012 and 2016, our team reviewed E’s medical records, obtained evidence from an expert Orthopaedic Surgeon, and drafted various witness statements from E’s friends and family to support his claim.

The Trust declined to send any statements or expert evidence in return and refused to admit responsibility for E’s injuries until April 2016. Even after admitting responsibility, the Trust continued to dispute the value of the claim.

Settlement achieved

In September 2016, just two weeks before trial, the Trust accepted our settlement offer. The £750,000 settlement will allow E to buy and adapt a bungalow. Due to the chronic pain in his leg, it is difficult for him to climb stairs, and we are confident that the move to a single-storey property will have a very positive impact on his quality of life.

Our specialist financial advisers provided E with independent financial advice to ensure that the substantial settlement will continue to support him.

Reflections on the case

“This was hard-fought and complex litigation in which the Trust accepted responsibility for the damage extremely late,” said the Tees lawyer in charge of the case. “In the end, the defence proved to be without foundation, and I was delighted that E received full compensation for his injuries with the opportunity to come back to court if he requires further surgery, such as an amputation or fusion, in the future.”

Client feedback

“We can’t thank you enough for your efforts in this marathon operation. The meeting went very well with Tees financial adviser, and we want to pursue some of the suggestions proposed, so we are going to be with Tees for some time to come,” said E, following the news that the settlement was accepted.

Free, confidential advice on medical negligence

If you believe you have suffered as a result of medical negligence, contact Tees Law for free, confidential advice. Our experienced solicitors are here to help you understand your options and seek the compensation you deserve.