Abstract
Introduction
We present the first 12 consecutive patients, undergoing elective paediatric limb reconstruction with an external fixator, for the 12-month period October 2020-October 2021. This is a single surgeon series for a newly appointed Consultant with limited previous experience. Arrangements were made for mentoring by a senior surgeon recently retired from the NHS but still active in private practice.
Materials and Methods
The average age of patients was 10.5years at the time of frame application (5—15 years). Four frames in three patients were for Blount's; two for sequelae of NF1; two for posteromedial tibial bow with shortening, two for fibula hemimelia; one congenital short femur, one for sequelae of neonatal sepsis and one for bone loss following tumour resection.
Results
We present early outcomes and complications for this challenging cohort. Two frames were revision frames, and a further two had had previous frame treatment. Where shortening was a primary component of the deformity (six cases) the mean lengthening required was 5cm (4–6cm)
Conclusions
The benefits of this arrangement include enabling newly appointed Consultants to take on complex cases from the start of appointment, dealing with enormous waiting pressures and minimising complications. The BOA reported this year that 25% of the over 45 consultant workforce intend to retire within three years. In this context, a renewed focus is needed on succession planning, proleptic appointments, and novel schemes to retain experienced surgeons within complex NHS practice: we present a successful example of this strategy.
