Leading the field to provide critical advice

All TLA clients are rightly concerned about the level of expertise assigned to their case, but any doubts can be quickly dismissed when they see the depth of expertise on offer.

Professor Alex Trompeter is an excellent example of how one of the top surgeons in the country draws on his in-depth knowledge to make him one of the company’s most sought-after experts.

As Professor in Orthopaedic Surgery at City St George’s, University of London hospital, he comments on all body trauma and specialises in complex trauma and limb reconstruction.

His specific clinical interests are the management of acute complex fractures – such as open fractures, periarticular fractures (those involving the joints), bone loss, and care of the multiply injured patient. He also offers specialist expertise in the management of bone infection, non-union, deformity correction and limb lengthening, and amputations. He collaborates closely with plastic surgeons on many cases and has a regular ortho-plastic-microbiology multi-disciplinary team clinic.

Professor Trompeter leads the limb reconstruction and complex trauma services for the region and is the lead orthopaedic consultant at the world-renowned Douglas Bader amputee centre at Queen Mary’s Hospital Roehampton.

After graduating from Guy’s and St Thomas’ medical school in 2003, he completed his specialist training in trauma and orthopaedics in the South West Thames rotation in 2012, having won the Sir Walter Mercer Gold Medal for the FRCS examinations in 2011 – achieving the highest overall mark for the year.

Prof Trompeter undertook specialist fellowship training in trauma and limb reconstruction in the UK (Royal Liverpool Hospital and Rowley Bristow Unit, St Peter’s Hospital Chertsey) and overseas (Foothills Medical Center Calgary, Canada). He was awarded the Braun travelling fellowship to the Massachusetts General Hospital in the United States by the British Orthopaedic Association and a further travelling fellowship to the Oxford Bone Infection Unit by the British Limb Reconstruction Society.

Actively involved in education locally, nationally and internationally, he holds a Postgraduate Certificate in Medical Education. He was Training Programme Director for the South West London Orthopaedic Rotation between 2018 and 2024. He previously sat as the Orthopaedic Trauma Society Committee Executive Member for education and meetings, organising several annual trauma conferences. Prof Trompeter is regularly found teaching and educating surgeons and allied healthcare professionals around the world.

Prof Trompeter travels to Ghana every year with both performing surgery and helping with education in terms of curriculum development on behalf of the AO alliance, the charitable arm of the largest and most recognised orthopaedic trauma education group globally.

As an active academic researcher, Prof Trompeter is widely published in his field and has successfully defended his PhD thesis in tibial trauma. He has more than 160 peer review publications, the majority in trauma and has edited two major textbooks.

For example, the September issue of The Bone & Joint Journal  featured a paper authored by Prof Trompeter discussing terminology for post-injury weight bearing instructions which have also been adopted into a new national guideline.  

He explained: “Weight bearing is one of my current big research themes. It's an interesting area to study because it's not about testing one implant against another or comparing one operation versus another. It is much more holistic looking at the patient journey and the rehab side of musculoskeletal injury, which often takes 90-95% of the patient journey.

“The operation itself is a very small episode compared to the time people spend learning to walk again or recover. It's not uncommon for many patients who have undergone lower limb fracture surgery to be told to not walk on the limb for several weeks to ensure the bone has a chance to heal before being loaded. That is unevidenced and a cultural approach to rehabilitation that most orthopaedic surgeons adopt – whilst in reality the evidence is starting to strongly show that early weightbearing and rehabilitation improve outcomes.

“I'm trying to change that culture because all of the science tells us that the earlier you start using a limb after injury, the better in terms of your functional outcome and there is no difference in the rate of complications.

“There are many negative impacts from being non-weight bearing, especially as you grow older and frailer. The article has also become a national guideline and is going to help inform the next round of research themes in this area.”

In addition, he works on implant design with the medical industry and conducts cross-collaborative work with universities and institutions such as Oxford and Imperial College, London as well as City St George's. Prof Trompeter supervises multiple research projects involving trainees and surgeons, as well as supervising numerous higher degree students. He is also the Research Chair for the British Limb Reconstruction Society.

Prof Trompeter sits on the Trauma Committee and the Clinical Standards Committee at the British Orthopaedic Association (BOA) and is the lead trauma representative responsible for producing UK guidelines in trauma including BOA Standards (BOASts). These are the key national guidelines that are often used in orthopaedic medical negligence cases – typically those involving compartment syndrome, open fractures, and numerous others. 

He explained: “I'm essentially co-chair of our national guidelines committee and have oversight of their writing and production. A lot of medicolegal cases, especially around negligence in orthopaedic trauma, can hinge on national guidelines at times. Being the person who writes those guidelines, understanding how they have come about and the reasons for their content puts me in a good position when it comes to discussing with the barrister the issues of liability.”

Prof Trompeter specialises in complex injuries, multiple injuries, amputation and compartment syndrome, Prof Trompeter receives instructions both for personal injury and clinical negligence for claiming and defending cases with all of his medicolegal casework managed by TLA.

He said: “I started working with TLA 10 years ago having been introduced to the firm by co-founder and Consultant Trauma Surgeon Stuart Matthews and as an Expert, I could not ask for better support. Indeed at the start of my medicolegal career, TLA were instrumental in sending instructions my way.

“As my reputation has grown, I receive more and more medicolegal referrals direct to me, yet I ask TLA to handle all these cases. They are the real experts in ensuring the cases are prepared properly and the appointments are all scheduled appropriately. A huge amount of my work now is repeat instruction from the same firms, or the same individual solicitors and I receive an increasing percentage of defending work, as well as maintaining a lot of claimant work covering a mix of personal injury and negligence.

“The TLA team cater for all my needs in terms of notes/imaging management, appointment scheduling, invoicing, liaison with instructing parties and dictation typing.

“I don't work with anybody else for my medicolegal practice and I'm increasingly busy which is fantastic, and I could not do it without TLA. TLA’s service is of the highest level and many of my instructing solicitors have commented on the team’s professionalism and efficiency. I have developed some key links with solicitors, regularly receiving repeat instructions and without TLA this would not have been possible.”

Despite his vast number of commitments, Prof Trompeter enjoys running and has completed several ultra marathons. Other hobbies include making salami and cured meats as well as gardening and of course spending time with his family and dog.

Please email Prof Trompeter’s medicolegal secretary, Alice, at alice@tla-medicolegal.com for his CV and further details.