The fellowship is set across two sites, including an adult major trauma centre where high volumes of acute complex polytrauma and periarticular trauma is managed (Aintree University Hospital), as well as an adult elective limb reconstruction centre where the full range of elective and orthoplastic limb reconstruction management is delivered (Broadgreen Hospital). Visits to the paediatric major trauma centre which also runs an elective limb reconstruction unit (Alder Hey Children’s Hospital) can be arranged with an honorary contract if required, however the fellowship is predominantly an adult placement.

These centres have been performing limb reconstruction surgery for more than 20 years, and as a result have a broad and deep experience of fellowship training within an established multidisciplinary team. The orthopaedic surgeons work alongside plastic surgeons, specialist physiotherapists, occupational therapists and specialist nurses to provide all aspects of limb reconstruction care for complex congenital and acquired pathology, using a wide variety of surgical techniques including internal and external devices, biologics and adjuncts to achieve optimal patient outcomes. We have previously provided high level fellowship training for surgeons from Germany, Spain, Italy, Greece, Egypt, Oman, Nigeria, South Africa, Brazil, India, Japan, China, Singapore, Malaysia, Kuwait, Saudi Arabia, Ireland, Australia & New Zealand.

The fellow forms an integral part of the unit and is encouraged to work independently, whilst remaining under the supervision of an experienced and enthusiastic consultant body. The fellow will be exposed to a large volume of complex clinical work in an outpatient, inpatient and operative setting. Operative experience is typically 80% supervised primary surgeon. We expect the fellow to participate in at least 8 elective theatre sessions, 4 trauma sessions, a multi-disciplinary meeting and 2 elective limb reconstruction clinic sessions each week.

By the end of our fellowship program, we would expect our fellow to have gained experience and competence in the following areas:

• The theory and practice of the management of major trauma, polytrauma and complex peri-articular trauma using an orthoplastic approach, using internal and external devices appropriately.
• The theory and practice of the management of acute and chronic bone infection using an orthoplastic approach and techniques including, but not limited to, bone transport, Masquelet, free tissue transfer, wound excision, debridement and dead space management.
• The theory and practice of the management of simple and complex deformities using techniques including circular frame (traditional fine wire Ilizarov and hexapod), external fixator assisted (LRS assisted –  ORDER) internal fixation, lengthening nails (FITBONE and PRECICE) or a combination thereof.
• Additionally, fellows will gain exposure to and understanding of how a major trauma network and centre functions, the wider LRS multidisciplinary team, congenital and acquired pathology.

Our unit is involved in research at the highest level, with recruitment to nationally organised and commissioned level 1 randomised controlled trials.  We expect the fellow to complete the NIHR Good Clinical Practice qualification (online course) and to take an active role in the recruitment of patients for ongoing research projects within our department.  Our consultants have high level national and international research experience. We are actively involved in NIHR research trials and on the research committee of the British Limb Reconstruction Society. Previous fellows have published extensively and won prizes at a national level for work produced in our unit.