DM brok arm abroad. Patched up but may need surgery. What pathway?

[brokenarmabroad]

On a city break in Europe with DM. Yesterday she slipped on ice and inured her arm. It obviously wasn't right so we went to the (excellent) local hospital who xrayed it and confirmed a severe break of both bones of her forearm. They tried twice to realign it but weren't fully satisfied with the result, and said it may need surgery. She's in a cast now, doing well in herself, and we arrive back in the UK late tonight.

I'm not sure where to go from here. Obviously she needs to been assessed and treated. Her GP surgery is worse than useless and doesn't even answer the phone. Should I just take her to A&E in the morning and hope for the best? Any medics on here who can advise on the best course of action?

Thank you!

You can either be referred to fracture clinic by your GP / ED or a minor injuries unit.

If you go to ED the best time is usually early morning.

Thank you everyone for your replies and advice. I hadn't even thought about the issue with flying and was reading them literally sat at the gate ready to board and so that was very much an oh shit moment! I was surprised they had given her a full cast straight away and not a back slab so that made me even more worried but I checked the NHS website and they said 24 hours for a 2 hour flight so I thought fuck it and we got on the plane - thankfully all was OK although I think my DM must have wondered why I kept looking anxiously at her fingers.

The consensus seemed to be a&e so we came this morning and despite the strike she was assessed by a nurse within about 20 minutes and has now been taken off somewhere. It's got busier since we arrived so I am glad we came early.

Thanks again!

Have you got the x-ray? If so, email it to GP, then follow up with a phone call requesting referral to orthos at the hospital.

Or, if that fails, phone the hospital and ask to speak to the orthopaedic secretary. Seek their advice.

If that fails, you have no choice but to go to A&E.

Option one should be doable and if it isn't then there is something very seriously wrong with the GP practice.

Glad the return home went smoothly and your DM is being seen. Hopefully surgery is not needed.

Ah - I see I missed the boat!! Good luck - hope it gets sorted quickly!

How’s it going @brokenarmabroad ?

Can she have the arm repaired privately via the insurance as she did it abroad? Wondering if she can use a private hospital instead?

Thank you for checking in muchtomuchtodo!

A&E wasn't too bad, all things considered. They xrayed her again and (as PPs predicted) have referred her to the fracture clinic which should take 7 to 10 days. I don't think she saw any ortho specialist though, and she doesn't think it was a doctor, but a nurse practitioner. I guess a radiographer would have reviewed the xray but I'm not sure.

DM saw today's xray and said it looked much better than the first one she had in the orginial hospital. She suspects that the fracture clinic are just going to say that it's good enough and not worth surgery. Obviously that's just speculation though and perhaps being a bit cynical. My concern is that the longer it goes without being properly assessed, the more complicated any further treatment becomes.

That's an interesting thought, ebonylion. I suspect not, but yiu never know and it wouldn't to any harm to ask. I'll pass the suggestion on to DM.

The other option is to get a private second opinion anyway - we could afford this if it meant a better long term outcome but she's feeling a bit done in and is thinking she might as well just wait now. I'm not sure how much to push this, ultimately its her choice.

I would go to a@e

That's an interesting thought, ebonylion. I suspect not, but yiu never know and it wouldn't to any harm to ask. I'll pass the suggestion on to DM.

Did she report it to her insurance abroad? In my experience, they'd have offered to sort it for her before she returned, but also have given her the option of treatment here once she was back if she'd prefer.

I broke my fibula a few weeks ago. Went to minors a couple of days later (I didn't realise it was broken!) and got a boot to wear. I didn't see a dr. It was the nurse clinician (I think that's what they're called). I got an appointment through for a week later to see the dr at the fracture clinic. I got another x-ray to see that it was healing ok with the boot on. If it hadn't been then I'd have been referred for surgery. Luckily it is so I'm now just bored at home!
I hope your mum is ok. I did the same thing by slipping on the ice!

@TakeYourFinalPosition , no she didn't report it - the hospital said there was no need for any payment at the time and it will probably be covered under EHIC anyway. Do you think the fact she didn't report it at the time will make a difference? I don't want to encourage her to call if she gets told that she would have got private treatment if only she had reported it, it will really upset her to know she's 'messed up'.

@Alittlebitofthis ,that is good to know the pathway worked for you, thank you for sharing. Hope you are recovered now!

I'm still in a boot! Going back to the fracture clinic next week again to see how things are.

It's too late now but they should have given you copies of the Xrays on a disc to take with you to hospital here. I broke my ankle while away from home here, the hospital gave me a letter & copies of my Xrays on disk they put my ankle in a back slab pot, I rang my local hospital & got an appointment for fracture clinic to get my ankle put in a full cast & to be treated as a patient.

She may not have seen an orthopaedic surgeon, but I think one will have reviewed her X-ray before saying it was ok to come back in a week or so. That’s what happened with mine at A and E, the Dr there thought I could probably go home and come back the next week for surgery but when the surgeon saw it he said no, the surgery need doing ASAP.

Pleased everything is generally ok and you got back allright

it may be partly cultural- many European countries will push for surgery and other treatments whereas in the Uk there seems to be a lot of waiting to see if things sort themselves out.

you went to the right place anyway, many times I’ve called and seen the GP and the answer has been “just go to a&e”. Once I was referred to the right part of the hospital and got to bypass a&e but I had to be really insistent to get this.

I hope you're right leapingcat. I'm not completely confident, I wish I had have gone in with her now because I would have asked that question explicitly. DM said there was no suggestion that anyone behind the scenes had reviewed the xray, and that in general it felt a bit chaotic with lots of being passed from one desk to another. Although she was seen quite quickly she said it didn't feel like anyone was really looking after her.

I have to say it was really sobering how much better the whole healthcare experience was in the original hospital (a former soviet state).

When my father broke his arm in France and needed surgery there, he received a bill when he returned home - the EHIC (now GHIC) only covers you to the same amount as a native would have been covered, and there was a balance to pay.

He did get excellent treatment though.

Actually, I’ve just remembered that when my DS broke his arm it wasn’t reviewed by a surgeon before we were sent home. But we got a call the next day to say the X-ray had been reviewed and he would need an extra check the following day. So I think all the X-rays must be checked eventually.

Slightly baffled about why you felt the experience abroad was so good - by the sound of it they’ve sent her on her way with a poorly reduced fracture, to take a flight in a complete cast and all without copies of the images or reports. That’s actually pretty poor care.

I had something similar happen and broke my arm. Xray showed an unstable fracture so I needed surgery.

The doctors gave me the option of having a cast, travelling and having surgery at home or being referred to the local hospital (who I knew had an amazing orthapaedic dept). I chose the latter and did have amazing care.