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A Comparative Risk Analysis of Malpractice Claims in Hand Surgeons Trained in Plastic and Orthopedic Surgery
Haad A Arif1,2, Bilal Khilfeh3, Fatima Z Arif4
1From the Department of Orthopaedic Surgery, University of Alabama at Birmingham, Birmingham, AL.
Plastic and Reconstructive Surgery. Global Open
|January 12, 2026
Summary
Residency training background influences medicolegal trends in hand surgery. Orthopedic-trained surgeons face litigation more often for fracture repair, while plastic and reconstructive surgery (PRS)-trained surgeons face it for soft tissue issues.
Area of Science:
- Orthopedic Surgery
- Plastic Surgery
- Hand Surgery
- Medical Malpractice
- Surgical Training
Background:
- Hand and wrist injuries are treated by both plastic surgeons and orthopedic surgeons.
- Significant clinical practice differences exist among hand surgeons based on residency training.
- This study investigates how residency training impacts medicolegal exposure for hand surgeons.
Purpose of the Study:
- To compare medicolegal outcomes for hand surgeons trained in orthopedic surgery versus plastic and reconstructive surgery (PRS).
- To identify factors influencing litigation risk and case types for different hand surgeon training backgrounds.
- To understand the relationship between residency training and malpractice claims in hand surgery.
Main Methods:
- A Westlaw database query identified jury verdicts and settlements against orthopedic and PRS hand surgeons.
- Data extracted included patient/defendant demographics, alleged negligence, damages, and payouts.
- 66 relevant cases were analyzed from 3933 initial records.
Main Results:
- Orthopedic-trained hand surgeons were involved in 78.8% of the 66 analyzed cases.
- Fracture repair was the most common preceding treatment (30.3%), followed by carpal tunnel release (19.7%).
- Therapeutic delay and patient death predicted plaintiff verdicts; PRS surgeons faced higher risks in soft tissue repair and amputation cases.
Conclusions:
- Residency training alone does not significantly alter overall malpractice litigation risk for hand surgeons.
- Differences in medicolegal trends reflect distinct training emphases, clinical experiences, and practice distributions.
- Understanding these differences is crucial for addressing medicolegal challenges in hand surgery.
