[Medical malpractice in the treatment of carpometacarpal osteoarthritis of the thumb - An analysis of data provided by the Arbitration Board for Medical Liability Issues of North Germany].

BACKGROUND:  Osteoarthritis of the first carpometacarpal (CMC) joint, also known as rhizarthrosis, is one of the most common diseases of the hand. Multiple medical and paramedical disciplines can be involved in the treatment. Interventional and surgical treatments may have a risk of complications and thus also of medical malpractice. In this paper, cases of medical malpractice in treatments of rhizarthrosis were analysed, in order to evaluate the quality of medical care.

PATIENTS AND METHODS:  Cases of medical malpractice with the diagnosis "Rhizarthrosis" (ICD-10 M18) from 2010 until 2018 were provided by the Arbitration Board for Medical Liability Issues of the Medical Associations of North Germany. The cases were allocated according to the medical specialty of the attending physician. Cases with verified medical malpractice were further evaluated and statistically analysed.

RESULTS:  44 cases with purported medical malpractice were found over a period of 9 years. In 16 of these cases, medical malpractice was verified (36.4 %): hand surgeons 8 of 24 (30.0 %), trauma and orthopaedic surgeons 6 of 14 (42.9 %), plastic surgeons 1 of 2 (50.0 %), general surgeons 1 of 1 (100.0 %) and 0 of 1 (0.0 %) each in the specialties of diagnostic radiology, radiation therapy and anaesthesiology. Surgeons with specialisation in hand surgery were responsible for 30.0 % (8 of 24) cases of verified malpractice, compared to 47.1 % (8 of 17) cases in other surgeons without this specialisation (p = 0.286).

CONCLUSIONS:  As surgical procedures for the treatment of rhizarthrosis are among the most common hand surgeries, the data shows that the treatment of rhizarthrosis in Germany is safe and has a very low rate of medical errors. Furthermore, medical malpractice in these cases is less frequent in surgeons with a specialisation in hand surgery compared to surgeons without this specialisation.