1 . An open fracture of his Ieft zygoma/cheek bone with skin and soft tissue Ioss.
2. A displaced fracture of his left clavicle.
3. A displaced fracture of his left scapula
4. Fractured left 1st 4th-8th ribs
5. Fractured spinous processes of T7-T9 vertebrae.
6. Left acetabulum fracture (pelvis).
7. Compression fracture T12 vertebral body.
8. Displaced fracture left ulna bone in forearm.
9. Grade 3b open fracture left tibia with marked comminution and bone Ioss.
10. Severe abrasions both ankles with skin and soft tissue Ioss down to bone.
Mr Jones underwent surgery to stabilise his left tibia, clavicle and ulna bone. In addition he underwent a free tissue transfer performed by the Plastic Surgeons at
Mr Jones is now currently convalescing at home. He is taking analgesics as required. He is still not able to use crutches and is mobile in a wheelchair. Mr Jones is going to have further surgery at
(ii)
Mr Jones received his diagnosis on the night of the accident when he was transported to the accident and emergency department at
Hospital (18th December 2007).
(iii)
Mr Jones is currently not able to put any weight through his Ieft Ieg and Ieft arm. He is using a wheelchair to mobilise. Therefore he is unable to walk. He is at present unable to negotiate any stairs. He is able to use his right arm and Ieg normally. He is able to use his left arm for personal care and Iight activities only.
Mr Jones was discharged from hospital on 14/02/2008. He was at that stage requiring morphine for pain. This can have an effect on cognitive function.
It is apparent from the above that Mr Jones is at present significantly disabled in terms of his abllity to perform basic daily activities.
(iv)
Mr Jones will make a good recovery from the majority of his injuries. The injury that will require the most time to heal in his severe Ieft Iower Ieg injury. The injury was such that the Ieg was nearly amputated just below the knee Ievel. The leg being held on by the posterior soft tissues. There was a Iarge amount of skin and soft tissue Ioss on the front of Mr Jones Ieg together with a Iarge amount of bone Ioss. It will be a significant challenge to get Mr Jones's leg bones to heal. He is likely to require multiple further operations to his Ieft Iower leg. The next operation is planned for the 27th of March 2007 at
In my personal experience the type of tibia fracture that Mr Jones has often takes in excess of 1 year to fully join. It is also important to note that the chances of Mr Jones's leg joining/healing are between 60 and 80%. If the tibia were not to join or there were significant infective complications it is possible that Mr Jones could require an amputation. If this were required I would anticipate that Mr Jones would very quickly be fully mobile and independent with the aid of a prosthetic lower limb. This is however only theoretical as there is every chance that Mr Jones tibia will go on to join over the next 12 months.
If Mr Jones's upper limb fractures heal without further intervention, as l anticipate he should be mobile with crutches over the next 4-6 weeks. Mr Jones will require crutches until his left lower leg heals/joins i.e. about 1 year if all progresses well.
It is therefore possible that once Mr Jones recovers from his next surgery he could return to work in a limited capacity. He is likely to require 3-4 weeks after his next surgery for postoperative wounds and postoperative pain to settle to an acceptable level. At that stage would anticipate Mr Jones to be able to perform a substantial proportion of his work. He would require some form of transport to work, as he would be unable to drive himself at that stage. If the stairs are of dimensions suitable to accept a person using crutches he should be able to negotiate the stairs.
The principle difficulty I can see is the ''standing for long periods'' aspect of Mr Jones's job. This would be difficult with Mr Jones only being mobile with crutches. It should however be possible for Mr Jones to stand for short-intermediate periods of time. Ideally with the ability to elevate his leg to reduce swelling periodically.
Once Mr Jones leg has healed he should be able to perform all aspects of his job.
(vi)
It is the severe left lower leg injury that is going to determine when Mr Jones is able to return to work an at what time he is able to resume normal duties. The other injuries should not have a significant impact on Mr Jones's working capacity. They are therefore unlikely to directly cause him to have further episodes of related illness in the future.
(vii)
In my opinion Mr Jones will be able to render regular valuable service in the near future. Mr Jones is likely to need further surgery to enable his left lower leg to heal. The first of these 27th March 2007. The exact number of further surgeries is not possible to predict. There is a chance that following the next planned surgery the leg
joins and no further surgery is required. If further surgeries are required they are likely to require Mr Jones to be in hospital for a few days with a short period of convalescence at home before returning to work.
(viii)
l am not an expert on the Disability Discrimination act of 1995 l have however studied the act and in my opinion Mr Jones would be classed as disabled for 'the purposes of the aforementioned act. Mr Jones's injuries will have a ''substantial adverse effect on normal day to day activities'' for example mobility. The effects of this are likely to last in excess of 1 year from the date of injury.
(ix)
Once Mr Jones has recovered from his next operation and provided that his 2 upper limb /arm fractures have joined, Mr Jones should be able to return to work in a reduced capacity.
Specific areas/recommendations that would assist Mr Jones are:
1 . A staged return to work.
2. Working from home where possible.
3. Assistance with transportation.
I believe the above to factually true and any opinions expressed are correct
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