Plymouth foot and ankle logo

    James Metcalfe

    Consultant Orthopaedic Surgeon

    James Metcalfe

    James Metcalfe

    NHS Practice

    Contact Details : NHS Address

    Orthopaedic Department,                
    Level 11,
    Plymouth Hospitals NHS Trust,
    Derriford Hospital,
    PL6 8DH.
    Telephone 01752 439175
    Secretary – Mrs Kate Williams

    James was appointed as a Consultant Trauma and Orthopaedic Surgeon at Derriford Hospital in January 2006. James has a busy practice including Paediatric Orthopaedic Surgery, Foot and Ankle

    Surgery in Adults and Trauma.

    Paediatric Orthopaedics

    James has regular children’s clinics based at Derriford Hospital but also outreach clinics in the community. James works with Mr Ben Holroyd and Mr Robert Jeffery who are consultant orthopaedic

    colleagues. James will see and assess any child with an orthopaedic problem.

    James has monthly clinics at Newton Abbott and in Cornwall. The Cornwall clinics are based at Bodmin Hospital and at the Child Development Centre at Treliske Hospital . James also has visiting

    Centre at Scott Hospital in Plymouth. 

    Developmental Dysplasia of the Hip (DDH)

    Derriford hospital has a multidisciplinary approach to DDH. James has a monthly clinic to assess children. James works closely with Dr Rima Vaitkute who is a Consultant Neonatologist and Mr Ben Holroyd. Clinics run on a Wednesday afternoon. In Children under 6 months of age ultrasound scans

    are performed. In older children X-rays are performed.

    Cerebral Palsy

    clinics at Woodlands Special School and Dame Hannah Rogers School and the Child Development

    In children who have cerebral palsy, there is an injury to the brain. This brain injury does not progress.

    There are several types of cerebral palsy but a common feature is that the muscles are excitable. This

    excitability is termed spasticity.  The spasticity in the muscles causes the muscles to be weak and short.

    Initial treatment is aimed at building up the muscle strength and to stretch out the tight muscles. To get the maximum benefit from these exercises they must be performed on a regular basis. It is good to

    think of these muscles as the muscles of an athlete. The muscles need to be developed by using them and then this muscle need to be maintained by continued use.  A physiotherapist will educate the child

    and parent of how to perform these exercises and will continue to monitor progress.

    The spasticity in the muscles may result in altered growth of the limbs. Muscles may become short.

    Bones may not grow and develop in a normal way. An orthopaedic surgeon can assess these changes and may be able to offer treatment. This may range from injections of botulinum toxin into muscles to reduce the excitability. Special splints may also help maintain mobility. Sometimes surgery to realign bones and joints may be required.
    Some children with cerebral palsy encounter difficulty with walking. Analysis of this walking may help

    guide further treatment and this assessment is called gait analysis. Gait analysis is performed at

    Plymouth Allied Health Centre on the campus of St Mark and St John. The analysis is performed by Professor Jon Marsden and usually takes about an hour to perform. The gait analysis requires walking

    up and down whilst wearing special markers on the body.  Once the analysis has been performed then Professor Marsden and James Metcalfe meet and discuss the results; a treatment regime is then

    suggested.  Physiotherapists are also invited. Parents and children are then invited back to clinic to share the results.

    Club Feet

    The treatment of club feet has been revolutionised by the use of the Ponseti method. This method was

    introduced to Plymouth by Mr Jeffery in 2003. The Ponseti manipulations are performed by physiotherapists . Sometimes the child need a small operation to improve the range of motion of the ankle . This is called a tenotomy and can be performed under general anaesthetic. If there is a relapse

    of the deformity later, then a more complex procedure may be needed and this may include correction

    of the deformity with an ilizarov frame.

    Limb Deformity Correction

    The lower limb in a child may not grow in the correct way leading to a deformity. This may result in an abnormal way of walking or symptoms of pain. This can be assessed using special X-rays and the

    level of the deformity can be found and a correction can be achieved. This correction may be achieved

    growth plate can correct the deformity. This is achieved by the use of screws and plates. If there are

    no growth plates then the deformity can be corrected by cutting the bone and using a special frame on

    by altering the growth of the bone. By stopping part of a bone growth plate from growing the remaining

    the outside of the bone to correct the shape of the bone. James has a large experience of such frames

    as the Ilizarov frame and the Taylor Spatial Frame. 


    James has an extensive experience of dealing with adult and paediatric trauma. James is on the on-call rota at Derriford hospital will assess and treat major upper and lower limb trauma. James has specialist skills in dealing with lower limb trauma and limb reconstruction with external fixators such as the Ilizarov frame and taylor spatial frame. James also has experience in treating complex foot and

    ankle trauma such as Lisfrac injuries, complex mid foot injuries and oscalcis fractures.

    treatment of these usually involves limb reconstruction with Ilizarov frames.

    James also treats the complications of trauma for instance non-union and malunion. Again the

    James has experience in treating children’s trauma and can assess and treat both upper and lower limb trauma. Broken bones in children will usually be treated in a cast but sometimes operations are necessary. James is able to treat such injuries and can treat long bone fractures with intra-medullary nails.