Orthopaedics

Although I have spent most of my professional life as a paediatric orthopaedic surgeon, my main research interest has been bone healing.

Treatment of fractures over the last 70 years have, in my opinion been sub minimal due the “misuse” of the biological sequence of events in fracture healing.

In order to produce callus (new bone) there must be movement between the fragments in the first few days/week. After this time no further callus is produced. But after that soft callus is formed it needs to ossifiy and form a bridge across the fragments. This requires prevention of movement (much like use glue to join to pieces of material. If there is continual movement while the glue is hardening, no union will be formed).

For historical and technical reasons, present day devices either attempt prevention of movement in the early stage and then  so-called dynamization or, as with intramedullary nails have real control over fracture movement.

I produced an External fixture which uses biology correctly and in a small trial of 15 patients we found excellent and rapid healing of tibial fractures.

Unfortunately it appears to be before its time and we were unable to raise any interest from orthopedic  surgeons or manufacturing companies.

The other film I have produced is to show junior doctors how to put on plaster casts properly.
 

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