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Paediatric Trauma and Orthopaedic Surgery

Children’s orthopaedics is recognised as a subspecialty of trauma and orthopaedics. The specialty deals with the treatment of children and young people aged 16 and under by trauma and orthopaedic surgeons, excluding spinal surgery.

Conditions treated include developmental dysplasia of the hip (DDH) and club foot, and neuromuscular conditions such as cerebral palsy, spina bifida, muscular dystrophy and arthrogryposis.

In children’s trauma, most of the work is made up by simple fractures sustained in low-energy falls. Major trauma in children tends to be dominated by head injuries but is less common.  It is estimated that over 8,600 patients under 16 years are seen every week in fracture clinics in England.

A key focus of the GIRFT report is the configuration of services through networks and pathways that fit the needs of children and their families and follow best practice. The recommendations seek to ensure that surgeons are better supported by networks, that unnecessary and avoidable admissions or hospital visits for children are avoided, and that unwarranted variation in operation rates are understood and tackled.

James Hunter

Clinical Lead for Paediatric Trauma and Orthopaedic Surgery

Mr Hunter is a paediatric trauma and orthopaedic surgeon at the Queen’s Medical Centre, Nottingham, where he has been a consultant since 1995. He took a full part in the adult trauma rota for 21 years before focusing solely on children’s care.

He is a past president of the British Society for Children’s Orthopaedic Surgery (BSCOS) and was the chairman of the AO International Expert Group for Paediatrics from 1997 to 2016.  He was a member of the Specialist Advisory Committee from 2013 to 2019, latterly as the lead for national recruitment of specialists.

He was one of the developers of the Comprehensive Classification of Paediatric Long Bone Fractures and has a strong interest in the treatment of simple fractures.  He was one of the authors of the BOA standard for trauma on supracondylar fractures of the humerus.

Realigned networks will improve access for children to specialised paediatric trauma and orthopaedic services

Matching surgical expertise and capacity through aligned networks for children’s trauma and orthopaedic services will strengthen pathways of care and the management of paediatric conditions, according to a new report from the Getting It Right First Time (GIRFT) programme. 

The configuration of services through networks and pathways that fit the needs of children and their families is a key focus of the GIRFT paediatric trauma and orthopaedic report.

The report’s author and GIRFT’s clinical lead for paediatric trauma and orthopaedics, Mr James Hunter, carried out a review of the specialty based on data from 128 trusts across England and virtual visits to 127 of those trusts. His report recommends that paediatric orthopaedic networks should align their boundaries with the Surgery in Children Operational Delivery Networks (SIC ODNs), helping to better co-ordinate care. 

Find out more about GIRFT’s data-led approach and best practice resources:

In April 2022, GIRFT published its national speciality report for Paediatric Trauma and Orthopaedic Surgery:

Click above to view the pdf report

Paediatric T&O Academy Resources