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The Orthopaedic Internet:

Quality Enigma

Chris Oliver is a specialist trauma and orthopaedic surgeon in the large University Teaching Hospital in Edinburgh, the capital city of Scotland. The Edinburgh Orthopaedic Trauma Unit in which he works is one of the busiest in the UK. He is responsible for the supervision and training of specialist orthopaedic trainees and visiting trainees from overseas.

The unit is almost unique amongst the world's major trauma units in that it is the only trauma unit serving a population of about 650,000 people. In most western countries such a population would be divided between more hospitals and the patients would be admitted to different hospitals according to the severity of their injuries. There is however no national trauma system in the United Kingdom and the Edinburgh Orthopaedic Trauma Unit takes all patients that present regardless of the degree of injury. This has allowed us to undertake epidemiological analysis of fracture populations and to also pursue clinical outcome of research for a wide spectrum of fractures.

Currently the unit admits about 4,500 patients per year and undertakes about 4,100 surgical operations. In addition approximately 38,000 out-patients are seen on an annual basis. Approximately 40% of the workload concerns fractures in the elderly with proximal femoral fractures accounting for just under 20% of all admissions. The challenging geriatric fractures are in fact the remaining 20% as these patients tend to be fitter and more active than those who have hip fractures. Much of the units time is taken up with the complex reconstruction surgery that these patients require.

The remaining 60% of patients are younger and frequently present with severe long-bone fractures, open fractures or multiple fractures having been involved in road traffic accidents. Unlike the elderly population the priority with younger patients is to return them to work as soon as possible as failure to do this is extremely expensive. The unit is well supported by the Department of Plastic Surgery at St John's Hospital who undertake much of the soft tissue reconstruction that is required in the management of these difficult injuries

He spends at least one day a week in theatre, conducting trauma operations, normally emergencies, and a further half day every week performing more routine emergency reconstructive surgery, mainly in the fields of hand and upper limb.

The remainder of his week is spent in out-patient clinics, in carrying out training and teaching commitments and participating in an on-call rota for emergency work.

Most of his routine operating timetable involves surgery of the upper limb joints, with a large number of hand surgery procedures, particularly in the more complicated cases of hand trauma. Although he has a specialist trauma practice within the Orthopaedic Trauma Unit he sees the whole range of orthopaedic diseases. Chris Oliver has developed special interests in surgery of the upper limb and in accident and trauma surgery, together with reconstructive surgery following trauma.

Chris Oliver has a major research interest in the development of the Internet in relation to Surgery. He has edited major orthopaedic websites and runs the Orthopod e-mail list which is the largest mailing list for orthopaedics and trauma worldwide. He is a founding member of Orthogate a "virtual gateway" to all trauma and orthopaedic information on the Internet.

My Community Activities

I had a previous life as a expedition whitewater canoeist and paddled on rivers in Europe, Yukon, Alaska, India and Turkey. I enjoy sailing, cycling, gardening and hill walking. Currently I am reading the "Harry Potter" books.


Undergraduate University College Hospital , London, England, MB BS BSc, Medicine plus honours intercalated BSc in Neurophy, 1984
Graduate Northwich Park Hospital , Harrow, England, Basic Surgical Training, 1986-88
Residency Robert Jones and Agnes Hunt Orthopaedic Hospital, Oswestry, England, Specialist Registrar Training Orthopaedics, 1994-1996
Fellowship Harborview , Seattle, Washington State, Trauma, 1996
Fellowship John Radcliffe Hospital , Oxford, Oxfordshire, Orthopaedic Trauma,
PhD Back Pain Service, Middlesbrough General Hospital, Cleveland, England, Doctorate of Medicine (DM) in Back Pain, 1995