The Penningtons Manches clinical negligence team has recently recovered damages of £400,000 for a client who was left with a severe foot drop following a fall resulting in a leg fracture and has represented several other clients who have suffered foot drop as a result of poor medical care. It can be a debilitating condition affecting many aspects of day to day life. People with foot drop often are unable to walk any significant distance, cannot participate in sporting and leisure activities, suffer from instability, can be restricted in their work capacity, and lose self confidence.
Foot drop is the inability to lift the foot and toes properly when walking. It is caused by weakness or paralysis of the muscles that lift the foot. People with foot drop tend to scuff their toes along the ground, so they may lift their foot higher than usual when walking to prevent this. Foot drop is often linked to damage or disease of the brain or spinal cord, although it may also result from injury to the nerves in the leg. If foot drop is caused by an injury or nerve damage, recovery is sometimes possible. However, if it is caused by a progressive neurological condition such as multiple sclerosis, foot drop will probably be a lifelong symptom to manage.
The client for whom the team won £400,000 in damages was admitted to hospital having fallen whilst climbing over a fence and broken his leg. He underwent surgery to pin the leg, which went well, but the signs that he was developing compartment syndrome were missed. Consequently, the client required major surgery to save his leg, necessitating a muscle transfer from his back and significant skin grafting. He retained his mobility but was left with a permanent and significant foot drop causing him regular pain and swelling in the leg. His injuries also prevented him from working and caused him a psychiatric injury.
Penningtons Manches is currently investigating a claim for a client who underwent hip replacement surgery during which her sciatic nerve was damaged leaving her with foot drop. She was returned to theatre for exploratory surgery where it was discovered that her surgeon had inadvertently sutured directly through her sciatic nerve. Sadly, the client now endures neuropathic pain and has reduced mobility and independence. Her injury is likely to be permanent.
Other scenarios in which clients are left with long term foot drop arise from neurological compression in the spine, often with very delayed investigation and surgery which result in permanent nerve damage.
Surgery can be beneficial for some foot drop injuries but patients are often simply left to make the best of it. There are some non-surgical options including physiotherapy and orthotics. An ankle-foot orthosis (AFO) is a device worn on the lower part of the leg to provide direct control of the ankle and foot. It is designed to hold the foot and ankle in a straightened position to improve walking.