My experience of the Hull Deformity Correction course

Fatima Rashid

Fatima Rashid is a ST6 Mersey orthopaedic trainee. At the September 2021 BOA Congress held in Aberdeen, she represented the Mersey region and was awarded the Best of the Best certificate for her talk on “Coronavirus in HIP Fractures (CHIP) study - A case matched multicentre study of 1,633 patients.”

As the winner of the ‘Best of the Best’ I was awarded a place at the Hull Deformity Correction course; a highly sought after fiveday course that runs annually. Delegates are from the UK but also many flew in from Europe and Africa. It is convened by Professor Hemant Sharma, who works at Hull Royal Infirmary bringing together specialist limb reconstruction surgeons from all over the UK and the world as fellow directors and faculty, both in person and virtually.

Even as a Yorkshire lass, I hate to admit I was not the most excited by the location, being well aware of Hull’s reputation. However, I was pleasantly surprised to learn Hull had more to offer than the Humber Bridge, as eye catching as it is. Hull was also awarded the UK city of

culture in 2017 and I could appreciate why. The old town is lined with cobbled streets and boasts a range of period architecture due to the wealth brought in through Hull being the largest whaling fleet in Britain in early 19th century.

It is the home of many artists including the poet Philip Larkin and Joseph Arthur Rank, founder of The Rank organisation, which owned five leading film studios and responsible for films such as Brief Encounter, Great Expectations and many of the Carry On series. And if culture doesn’t excite you, many may be surprised to learn that in 1856, Thomas James Smith opened a chemist’s shop in Hull, establishing his business by selling cod liver oil to hospitals. In 1896 the company was joined by his nephew, Horatio Nelson Smith, forming Smith and Nephew, the billion pound global medical devices business, us orthopaedic surgeons are well aware of today.

The course was held at The Hilton Hotel, with a decent discount offered for anyone who wanted to stay there, inclusive of breakfast. This perk certainly helped the short daily morning commute.

A pre-course day was offered to any of the participants that were less experienced in deformity correction, an offer I took up without thinking twice, as my only experience involved three months at the paediatric orthopaedic unit in Alder Hey. It was more than useful, as it allowed me to grasp basic understandings of limb reconstruction, devices used, osteotomy techniques, selecting the correct patient and how to manage them pre and post op. Practical saw bone workshops then allowed the participants to familiarise themselves with different kit available, including the Smith and Nephew TSF/Ilizarov and the Orthofix TL Hex/Truelok frame.

To aid us with the planning workshops we were all given a bag of ‘goodies’ that included coloured pencils, ruler, protractor, sharpener, eraser and a workbook. A member of the faculty then took us through step by step on how to plan a deformity correction. Each table also had a faculty member to help us, any time we reached out for the eraser. It felt like I was back at school in the most pleasant sense. There was a lot of care and attention taken to ensure we understood the concepts and were able to apply them correctly.

For the saw bone workshops, a short demonstration was performed, before we were able to get our hands on the kit. With orthopaedic surgeons being likely kinaesthetic learners, the saw bone workshops were invaluable. We first used software provided to plan the case and then built our frames and watched our deformity correction come to life. Time certainly flew by in these workshops. I definitely value the need for courses that have a heavy practical component.

We also had the opportunity to have a day out to Hull University, to the cadaver lab. It was a short ride on a coach, again reminiscent of school days. Naturally, I sat in the back row, bonding with fellow orthopaedic surgeons. No time was wasted in the cadaver lab, as we got straight into a series of ‘operations’ such as tibial osteotomy, achilles lengthening, peroneal release, that we performed on our cadaveric leg, in turn, within our small groups, guided by a faculty member. I particularly enjoyed the cadaveric session as it highlighted the ‘real life’ element of limb reconstruction, and to understand the importance in considering the soft tissues.

There were ample opportunities to complete work based assessments that were encouraged by the faculty. This was especially helpful when gaining PBAs for osteotomies as this procedure can sometimes be a challenge to attain whilst training.

The last day was a combined day with SICOT with a live telecast, titled, current concepts in limb reconstruction. There were a number of very interesting talks, including one on war injuries, which I found fascinating. I have to admit by the end of the week, I was exhausted by all the excitement and learning and therefore my concentration did dwindle by the afternoon. Fortunately, it was recorded, and accessible at a later date.

The course dinner, took place at Tapasya, located at Hull’s marina. It was a lovely opportunity to socialise with both delegates and faculty, as well as taking in the view of the marina. I also particularly enjoyed the Indian set menu and could not have asked to enjoy it in better company. I also had the opportunity to visit the oldest pub in Hull ‘Ye Old Black Boy’, to experience the history of the old town.

I believe every orthopaedic trainee would benefit from attending this course regardless of their specialist interest. In particular the beauty of this course was; not assuming detailed prior knowledge, emphasis on the practical component, small groups with high ratio of faculty to participants and the creation of a friendly and safe environment that allowed ample opportunities for questions and discussions. This allowed all participants at all levels to develop their understanding and skills. This was, of course, all down to an enthusiastic, friendly, passionate, knowledgeable yet humble faculty who all gave up their precious time to teach their specialist subject of deformity correction.

Although, I was fortunate to win a place on this course, after experiencing one of the most organised, welcoming courses I have attended, I would, in fact, have happily paid for it. •