Compensation claims in pediatric orthopedics in Norway between 2012 and 2018: a nationwide study of 487 patients

Figures & data

Figure 1. Compensation claims received by NPE from 1988 until 2020. White area represents the time period of the current study (2012–2018).

Table 1. Compensation claims received by NPE 2012–2018 according to the 5 most common medical subspecialties

Medical subspecialties	Number (%)
Orthopedics	10,861 (29)
Oncology	5,183 (14)
Dentistry	3,245 (9)
Psychiatry	2,179 (6)
Gastroenterological surgery	1,643 (4)

Table 2. All claims listed in groups according to the ICD 10 classification system and number of claims granted. Values are count

Diagnoses (groups)	Claims	Granted
S40–S69 Acute injuries in the upper extremity and T92 sequela (n = 129)
S40–S49 Injuries of shoulder and upper arm	51	13
S50–S59 Injuries of the elbow and forearm	49	14
S60–S69 Injuries to the wrist and hand	18	10
T 92 Sequelae	11	2
S70–S99 Injuries in the lower extremity and T93 sequela (n = 115)
S70–S79 Injuries to the hip and thigh	24	9
S80–S89 Injuries to the knee and lower leg	65	19
S90–S99 Injuries to the ankle and foot	24	6
T93 Sequelae	2	1
Q65–Q79 Congenital malformations and defor-mations of the musculoskeletal system (n = 59) including M16.2–M16.3 secondary arthritis
Q65 Hip dysplasia and sequelae	36	9
Q66 Congenital deformities of feet	8	1
Q68–Q79	15	2
M40–M54 Deforming dorsopathies, spondylo-pathies, and other dorsopathies (n = 52)
M40–M43 Scoliosis	44	14
M45–M54	8	1
M20–M25 Arthropathies (n = 46)
M20 Acquired deformities fingers/toes	8	5
M21–M22 acquired deformities, patella	13	0
M23 Internal derangement of knee	11	7
M24–M25 Other joint disorders	14	5
M91–M94 Chondropathies (n = 30)
M91 Juvenile osteochondrosis pelvis	5	1
M92 Other juvenile osteochondrosis	5	1
M93 Other osteochondropathies	20	12
Others (n = 56)
D16, L60, M00, M67, M84, M86, P14, T01, T14 Benign neoplasm, superficial injuries, wounds, pelvic and spine fractures, osteomyelitis	56	18

Table 3. Most common specific diagnoses and information on the number of submitted and granted claims, and reason for granting in children aged 0–17 years. Values are count

		Reasons for granted compensation
Most common specific diagnoses	Claims	Granted	Diagnostics	Treatment	Exceptional rule
S40–S69 Acute injuries in the upper extremity and T92 sequela (n = 129)
S42.2 Fractures proximal humerus	5	0
S42.4 Fractures distal humerus	33	9	1	7	1 ^A
S52.5 Distal radius fracture	12	1		1
S52.4 Antebrachii fractures	11	2		2
S53.1 Dislocation of elbow	5	2	2 ^C
S62.0 Scaphoid fracture	4	3	2 ^D	1
S62.3-S62.6 Finger/metacarpal fractures	5	4	1 ^D	3 ^2 E, 1 F
S63 Subluxation/dislocation, ligament rupture	5	3	2 ^D	1 ^F
S70–S99 Injuries in the lower extremity
S72 Femur fractures	19	7	2	5 ^3 G, 2 H
S82.2 Fracture of shaft of tibia	6	2		2
S82.3 Fracture lower end of tibia	7	4	2 ^1 D, 1 I	2 ^1 J, 1 K
S82.5; S82.6 Fracture medial or lateral malleolus	5	1		1
S83.5 Sprain of cruciate ligament	13	3	1	1	1 ^A
S93 Dislocation and sprain of joints and ligaments at ankle/foot/toe	6	1		1
M40–M54 Deforming dorsopathies, spondylopathies, and other dorsopathies
M41.1 Juvenile idiopathic scoliosis	5	1	1
M41.2 Other idiopathic scoliosis	14	5		3 ^1 L, 2 M	2 ^A
M41.4 Neuromuscular scoliosis	8	2		2
Q65–Q79 Congenital malformations and deformations of the musculoskeletal system
Q65.0–Q65.9 uni- or bilateral DDH	25	8	6	2
M20–M25 Arthropathies
M20.1 Hallux valgus	8	5		5 ^4 N,1°
M22.0 Recurrent dislocation patella	5	0
M23.2 Old meniscus tear	4	2	1 ^D		1 ^A
M23.5 Chronic instability	6	4		3 ^P	1 ^A
M91-M94 Chondropathies
M91.1 Perthes disease	5	1		1
M93.0 Slipped capital femoral epiphysis (SCFE)	15	10	9 ^D	1 ^Q
M93.2 Osteochondritis dissecans	5	2		2 ^R

Detailed information on the causes of compensation for all specific injuries/conditions with > 3 compensations claims submitted to NPE within the time period 2012–2018.

A: infection, B: unexpected severe injury, C: delayed diagnosis of accompanying injuries, D: delayed diagnosis, E: malrotation, F: iatrogenic nerve injury, G: malalignment; H: compartment syndromes in contralateral lower leg due to peroperative hemilithotomy positioning, I: delayed diagnosis compartment syndrome, J: inadequate surgery, K: inadequate conservative treatment; L: iatrogenic spinal cord injury, M: lack of follow-up, N: lack of indication, O: delayed secondary surgery, P: surgical errors, Q: not specified, R: inadequate removal of foreign body, 1 inadequate follow-up.

Table 4. Incidence of claims granted in relation to extrapolated occurrence of pediatric fractures in children aged 0–15 years

Type of fracture	Claims granted in children 0–15 years	Incidence per 10^5 children 0–15 years ^a	Extrapolated no.per year ^b	for the study period	Incidence of claims granted (%)
S42.4 Fractures of the distal humerus	8	14	1,384	9,688	0.08
S62.3 Finger/metacarpal fractures	2	32	3,110	21,770	0.009
S52.4 Antebrachii fractures	2	9.5	932	6,525	0.03
S72 Femur fractures	3	1	98	686	0.4
S82.2 Fractures of shaft of tibia	2	8.7	853	5,971	0.03

a Epidemiological data published by Randsborg et al. (2013) based on children aged 0–15 years. To allow for extrapolating of data only claims in children of the same age (0–15 years) are considered in this table.

b Incidence of pediatric fractures per 10,000 children (age 0–15 years) was extrapolated to the population of the whole country (981,342 children aged 0–15 years) based on data provided by Statistics Norway (Statistics Norway 2020).

Table 5. Incidence of claims for pediatric hip diseases in relation to data provided by the Norwegian National Pediatric Hip Registry

Pediatric hip disease	Claims	Claims granted	Total no.of reported cases^a	Incidence of claims granted (%)
Q65.0–Q65.9 DDH	23^b	8	390^b	2.0
M91.1 Perthes disease	5	1	352	0.2
M93.0 Slipped capital femoral epiphysis	15	10	298	3.3

a Total number of reported cases for the study period are provided by the Norwegian National Pediatric Hip Registry (Barnehofteregisteret 2021).

b The Norwegian National Pediatric Hip Registry provides data for late detected DDH (> 3 months). Only late detected cases are included from both the claim registry and the Norwegian National Hip Registry.

Randsborg P H, Gulbrandsen P, Saltytė Benth J, Sivertsen J E A, Hammer O-L, Fuglesang H F S, Arøen A. Fractures in children: epidemiology and activity specific fracture rates. J Bone Joint Surg Am 2013; 95(7): e42.

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