As personal injury lawyers, who are employed to represent clients injured in motor vehicle accidents (MVA’s), it can be challenging to “get up to speed” on the human body, including the parts most affected when clients are involved in MVA’s. How can I help you? Here are some simple ways to assist you better understand common terms used in medical evidence in PI and med neg matters, particularly with respect to bones of the back, face, arms and hands, which form part of the musculoskeletal system, where many injuries occur in MVA’s.
Bone fractures always require medical attention and may require surgery, so references will be common in medical notes for clients who have been involved in MVA’s. Maybe you have read the following abbreviations in clinical or surgical notes in respect to the backbone (vertebral column) and have been unsure of there meaning. Heres some tips:
Vertebral Bones (Back Bone)
- C1- C7 = cervical or neck bones
- T1 – T12 (or D1- D12) = thoracic spine
- L1 – L5 = lumbar spine
- Sacrum = slightly curved, triangular shaped bone
- Coccyx = tailbone
Cervical injuries include whiplash, disc injury or dislocation. The lower back is the most common site of injury, from sprains and strains to herniated discs and fractured vertebrae. Injuries to the back bones can often cause lifelong problems, including nerve pain and numbness, causing life long pain and discomfort with the most severe cases causing permanent paraplegia or quadraplegia.
Facial Bones
Or maybe a client has face fractures, it would help to understand the following:
- Nasal bones (nas/o means nose) = bones that support the bridge of the nose
- Lacrimal bones (lacrimal/o means tear) = bones located at the corner of each eye
- Maxillary bones = massive upper jaw bones (maxillae)
- Mandibular bone = lower jaw bone (mandible)
- Zygomatic bones = two bones on each side of the face which forms the high portion of the cheek
- Vomer = bone that forms the lower portion of the nasal septum
Facial injuries can range from scrapes and bruises to lacerations and fractures, even serious facial fractures which can damage the jaw, teeth or eyes leaving people with vision problems, disfigurement and/or nerve damage.
Arm and Hand Bones
Broken arms and hands are very common and are referred to in medical notes as:
- Humerus = upper arm bone
- Ulna = medial (or central/middle) lower arm bone
- Radius = lateral (or to the side) lower arm bone
- Carpals = wrist bones
- Metacarpals = 5 radiating bones to the fingers
- Phalanges (singular phalanx) = finger bones
A wrist or hand fracture can leave a person unable to work for quite some time. They can be slow healing and may require pin fixation to repair with limited range of movement to follow.
Bones of Leg & Foot
This is a common injury in MVA’s and can involve the following bones:
- Femur = thigh bone
- Patella = kneecap
- Tibia = largest of 2 bones of the lower leg
- Fibula = smaller of 2 lower leg bones
- Tarsals = ankle bones
- Metatarsals =5 bones in the foot between the ankle and the toes
- Phalanges = bones of the toes
Types of Fractures
The common terminology or vocabulary for the various types of fractures include:
- Closed fracture = broken bone with no open wound
- Compound fracture = broken bone with bone breaking the skin causing an open wound
- Colles’ fracture = a wrist fracture
- Comminuted fracture = bone is splintered or crushed
- Compressed fracture = bone is compressed (often in the back)
- Greenstick fracture (childhood break) = bone is partially broken and partially bent
- Impacted fracture = one fragment of bone is driven firmly into the other.
- Hairline or stress fracture = often occurs in leg or foot bones, a small crack in the bone
- Avulsion fracture = bone fragment that pulls away from the main bone mass.
Compound fractures often result in infection which can compromise the healing of the bone and make it more complicated.
Treatment of Fractures
Treatment of fractures involves either surgery or manipulation to restore it to its normal position, the procedures include:
- Reduction = restoration of the bone to its normal position
- Closed reduction = manipulative restoration without surgery
- Open reduction = an incision (surgical cut) is required to the fracture site.
Fractures will often require a cast, surgery and/ or manipulation, in combination or as a stand alone treatment.
In my view, possessing medical knowledge involving terminology, surgical procedures, procedures, pathology, treatments etc is invaluable, when assisting clients in PI and med neg cases. It can be gained through experience, but everyone starts out with no medical knowledge when entering PI or med neg as a lawyer. Im firmly of the view having medical knowledge is an asset when running a PI or med neg case, even if only to better understand the medical evidence.
I wrote an earlier blog on “How To Understand Neuro Terms…So You Feel Like An Expert” which provides helpful information about the brain, another common area of injury in MVA’s. Go to my website at http://www.sydneybarrister.net.au under the Tab “Blog” to read more about neuro terms and abbreviations and this will increase your knowledge even further.
I run lunch and learn sessions, on a variety of legal topics, which assists law firms improve their knowledge and skills in family law and personal injury and medical negligence. I invite you to email me on louise.mathias@sydneybarrister.net.au before 1 October 2015, to set up a time to talk about me presenting at your firm, before the end of the year, on the topic of “At Last…The Secrets To Medical Documentation in PI and Med Neg Matters…Revealed!” or another topic that you may find more suitable for your firm.