Güven Asim, Asiri Mohammed Nasser, Allert Sixtus
Sana Klinikum Hameln-Pyrmont, Plastische und Ästhetische Chirurgie, Handchirurgie.
Handchir Mikrochir Plast Chir. 2020 Feb;52(1):6-10. doi: 10.1055/a-1075-2817. Epub 2020 Mar 5.
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.
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.
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).
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.
第一腕掌（CMC）关节骨关节炎，又称拇指腕掌关节病，是手部最常见的疾病之一。多个医学和辅助医学学科可能参与其治疗。介入治疗和手术治疗可能存在并发症风险，进而也存在医疗事故风险。本文分析了拇指腕掌关节病治疗中的医疗事故案例，以评估医疗质量。
2010年至2018年期间，由德国北部医学协会医疗责任问题仲裁委员会提供诊断为“拇指腕掌关节病”（ICD - 10 M18）的医疗事故案例。这些案例根据主治医生的医学专业进行分类。对已证实存在医疗事故的案例进行进一步评估和统计分析。
在9年期间共发现44例疑似医疗事故案例。其中16例被证实存在医疗事故（36.4%）：手外科医生24例中有8例（30.0%），创伤与骨科医生14例中有6例（42.9%），整形外科医生2例中有1例（50.0%），普通外科医生1例中有1例（100.0%），诊断放射学、放射治疗和麻醉学专业各1例中分别有0例（0.0%）。手外科专科医生负责30.0%（24例中的8例）已证实的医疗事故案例，相比之下，其他非该专科的外科医生负责47.1%（17例中的8例）的案例（p = 0.286）。
由于拇指腕掌关节病的外科治疗是最常见的手部手术之一，数据表明德国的拇指腕掌关节病治疗是安全的，医疗差错率非常低。此外，与非手外科专科的外科医生相比，手外科专科医生在这些案例中的医疗事故发生率较低。
