Specialist training provides deep insight into personal injury cases

Medicolegal specialists possess vast knowledge and experience and are often internationally recognised pioneers in their field meaning their expert reports are unparalleled.

But not that many can claim to have travelled to Siberia to study a surgical method that would form a major part of their practice to this day.

Consultant trauma and orthopaedic surgeon Simon Britten did just that to learn the Ilizarov method, a technique originally pioneered by Gavriil Abramovich Ilizarov, a Soviet doctor who treated injured soldiers returning from World War Two.

The process is used for high energy fractures, fractures with loss of bone leading to bone defects and shorter limb length, and other conditions of limb shortening including growth plate injuries and skeletal dysplasias.

It is a complex orthopaedic procedure that involves cutting and separating the bone of the affected limb, then gradually lengthening it over time while also lengthening the surrounding muscles and tendons.

“Ilizarov was an orthopaedic surgeon in Western Siberia and had thousands of Russian servicemen returning from the war with neglected injuries - infection, deformity, non-union. So, he invented the method with limited resources to treat those injuries. It was only really as the Iron Curtain started to come down in the late 1980s and early ‘90s that we became aware of the Ilizarov method in the West,” explains Mr Britten.

“In 2001, Smith and Nephew started up two-month fellowships in the Ilizarov Centre in Kurgan, Siberia. Another colleague and I were the first UK surgeons to undertake a two-month fellowship at the institution,” explains Mr Britten. 

“I returned several times over ensuing years spending a total of four months at the Centre.”

As a result, Mr Britten specialises in lower limb trauma including fragmented fractures and open fractures where the bone has come through. 

“Sometimes there are problems with fractures not healing or being infected or not aligned properly which is the original reason the Ilizarov method was invented,” he says.

Prior to this, Mr Britten’s career started as a house and senior house officer in both the military and the NHS following qualification from Southampton Medical School in 1990. 

He adds: “I then left the Army and started full time with the NHS in 1993. I did my basic surgical training in Bath, my higher surgical training in Bristol and was then appointed as a consultant in Leeds.

“At the time, that was at St. James's University Hospital – known as Jimmy’s – and it was one of the busiest trauma centres in the UK. I have since been in Leeds for 23 years.”

Mr Britten is the immediate Past President of the British Limb Reconstruction Society and spent three years as chair of the British Orthopaedic Association Medico-legal Committee. Currently he is a corresponding member of the Leg Lengthening and Reconstruction Society of North America.

He is also editor of the next edition of Medicolegal Reporting in Orthopaedic Trauma, widely regarded as the industry bible, succeeding Mike Foy and Phillip Fagg who have now retired.

“This will be very much part of my medicolegal work. It's the go-to book for personal injury reporting in the UK. If you want to know what the outcome is after a certain orthopaedic injury and you're not sure, you look it up and all the medical evidence is set out so you know what outcome to expect after a certain injury,” adds Mr Britten.

TLA co-founder Stuart Matthews is writing one of the chapters with the pair having first met when Mr Britten started at St. James's University Hospital in 2002.

Significantly, in 2018 Mr Britten was awarded a Master of Laws degree in Medical Law and Ethics from De Montfort University Leicester, although he has been performing medicolegal work for 25 years.

“That also helps with the medicolegal work as it gives me a wider understanding of the law. While orthopaedic expertise is what is needed for report writing, having a basic understanding of medicolegal law does help improve the standard of my reports.”

Mr Britten produces up to 50 expert reports a year covering complex lower limb injury and Illizarov cases, along with multiple injuries including polytrauma where patients have a frame on one limb but also have injuries to other limbs. Most involve personal injury although he does take on a small number of clinical negligence cases.

Recently, he started working with TLA as a full Member with the team handling all of his case load and administration.  

“I previously worked with a secretary at the Nuffield Hospital in Leeds when I was doing only a modest amount of medicolegal work. I then organised my practice myself, with varying results as it is difficult when you are a busy clinician.

“Being relieved of the admin will mean I can spend more time writing the reports safe in the knowledge that there is somebody that can deal with that and arrange things for me.”

It will also allow him to pursue his wide range of hobbies and interests which range from Nottingham Forest Football Club and Leeds Rhinos Rugby League team to the Castles of Northumberland, Formula One motor racing and modern languages.

He adds: “I speak French, some Russian, a little Ukrainian, and I enjoy old Gothic horror movies!”

Please email Alice Jones, Senior Case Manager and Head of the Trauma and Orthopaedics Division at TLA for Mr Britten’s CV and further details alice@tla-medicolegal.com