Hi, I'm Nik Jagodzinski, a Consultant Hand, Wrist and Orthopaedic Trauma Surgeon based in Barnstaple, North Devon, working for the Royal Devon University Healthcare NHS Foundation Trust. I live to help people with hand and wrist problems.
Nik with one of his colleagues whilst working in Malawi.
I offer the full spectrum of hand and wrist surgery including complex hand and wrist fractures, knuckle replacements and fusions for arthritis, upper limb nerve and tendon surgery, Dupuytren's disease, lumps, bumps and tumours and many other common Hand and Wrist Conditions.
I also treat some soft tissue elbow problems such as tennis and golfer's elbow. My specialist interest is WALANT surgery, Wide Awake Local Anaesthetic No Tourniquet. Using this technique, I can perform most hand and wrist procedures in a safer, quicker and cheaper way than using General or Regional anaesthesia, whilst also producing better outcomes. If you want to learn more, head to my WALANT page.
I set up and run the South West Association of Surgery for the Hand (SWASH) and I am an active member of the British Society for Surgery of the Hand (BSSH). I sit on their Global Partnership Committee, regularly visiting many LMICs (Low-Middle Income Countries) on charitable missions around the world to teach hand surgery and the WALANT technique.
My Surgical Training And Experience
With my Primary and Secondary schooling in Devon, I class myself as a local, even though my surgical training has taken me all around the world. I qualified as a doctor from the University of Manchester in 2002 then completed my House jobs in Manchester too. I then completed a Senior House Officer rotation in Brighton and Worthing with an Emergency Medicine slant and worked as a middle-grade Emergency doctor for several years alongside completing basic surgical training at various locations along the South coast. I gained experience in Plastic Surgery, General Surgery, Neurosurgery and Intensive Care Medicine before becoming a Member of the Royal College of Surgeons of England in 2006. My love of Orthopaedics throughout this period made the decision to specialise easy...
Orthopaedic Registrar training included specialist placements in Birmingham Children's Hospital and the Royal Centre for Defence Medicine in Birmingham as a Trauma Research Fellow during the Afghanistan and Iraq wars. After further Orthopaedic training in Peterborough, I then rotated around hospitals in Devon and Cornwall until I became a Fellow of the Royal College of Surgeons of England in 2014.
Prof Don Lalonde and his registrar performing WALANT surgery under field sterility.
My Interest in Hand Surgery started pretty early in my career during SHO placements in Orthopaedics and Plastic surgery and then registrar placements in Birmingham, Peterborough, Cornwall and Devon. I won the Ronald Raven Barber's Award in 2014 which sent me to Canada to learn WALANT surgery from Prof Don Lalonde, the President of the American Hand Surgery Society. The remit of the award was to bring surgical innovation to the UK from abroad, and it certainly achieved that!
Amongst all of my training to date, this has been the most influential time of my career, as you can read in our WALANT page.
Prof Don Lalonde performing a WALANT injection
Winning a second prestigious award sent me to the famous Ganga Hospital in Coimbatore, India, to complete the Bruce Bailey Fellowship with Dr Raja Sabapathy. Here, arguably some of the best hand surgeons in the World taught me basic and advanced Microsurgical and Plastics Reconstruction skills, as well as a grounding in personal ethics and surgical discipline. I strongly believe this is the primary reason their reputation at Ganga is second-to-none.
Nik Jagodzinski and Dr Raja Sabapathy
Ranking first in the UK national application and interviews for TIG (Transitional Interface Group) ortho-plastics Hand Fellowships, I was able to choose Oxford as the location for my final hand and wrist specialist training. During my year at Oxford, I was able to learn from over 20 of the UK's top subspecialist hand and wrist surgeons to ensure I was equipped to offer the full range of specialist knowledge, skills and techniques required to help my patients in the most evidence-based and advanced way possible. During this Fellowship, I also completed the UK Diploma in Hand Surgery and was awarded the Vivien Lees Gold Medal for the highest score in the country in 2016.
Nik receiving his Vivien Lee's Gold Medal with Chris Little and Ian MacNab.
After completing my Orthoplastics Interface Fellowship in Oxford, I returned to the South West to complete my Senior Registrar training in Exeter as a hand, wrist and trauma surgeon, gaining my Certificate of Completion of Training in 2016. After a short stint working as a locum Consultant in Exeter, I relocated to Barnstaple for my substantive Consultant role. Here, I had the opportunity to set up a hand and wrist specialist practice where there had previously been none. Working in the most remote acute hospital in mainland England, it helps to be able to offer the full spectrum of hand and wrist surgery to patients to save their travel costs, time and carbon footprint.
As a sole hand surgeon in a region, it is vital to keep abreast of new techniques and knowledge and link with other teams to discuss complex patients and to ensure continued evidence-based and peer-reviewed practice. As well as attending regular national hand conferences, I also review articles for the Journal of Hand Surgery - European Volume. More locally, I regularly link with Hand MDTs (Multidisciplinary Team) in Exeter and around the South West of England.
Nik with hand surgery colleagues from Exeter and Taunton
In 2019, I set up, organised and led the inaugural South West Hand Network meeting for all hand and wrist surgeons from Cornwall to Bristol. Due to unanimous excellent feedback and a request from the group, I continued to lead this regional network, renamed SWASH (South West Association for Surgery of the Hand) for several years. Through this, I have unrivalled local, regional and national support and governance validation for my Consultant practice.
Nik's Work with the BSSH Global Partnership Committee
If you would like to read about my work with the BSSH, please visit my BSSH Partnership page.
Nik's Publications
As well as being a previous reviewer for the Journal of Hand Surgery - European Volume, I am also well published myself:
Lalonde D. Wide Awake Hand Surgery and Therapy Tips. 2nd Edition. Image Cover
Published Book Chapters
- Lalonde D. Wide Awake Hand Surgery and Therapy Tips. 2nd Edition. New York: Thieme; 2021. Doi:10.1055/b000000319. ISBN 9781684202300. I am a co-author on chapters:
- Chapter 2. Phillips A, Jagodzinski NA, Lalonde DH. Advantages on WALANT for patients, surgeons and anaesthesiologists.
- Chapter 7. Jagodzinski NA, Phillips A, Lalonde DH. Tips on explaining WALANT to patients before surgery.
- Chapter 10. Moving surgery out of the main operating room with evidence-based field sterility.
- Chapter 44. Distal radius and forearm fractures
- Lalonde D. Wide Awake Hand Surgery. CRC Press. 29.02.2016. ISBN 978-1-4987-1479-2 - CAT# K25310. I am a co-author on 4 chapters in this 1st edition textbook:
- Chapter 2. Phillips A, Jagodzinski NA, Lalonde DH. What is wide awake hand surgery?
- Chapter 5. Lalonde DH, Jagodzinski NA, Phillips A. How to inject local anesthetic with minimal pain.
- Chapter 7. Jagodzinski NA, Phillips A, Lalonde DH. Tips on talking to your patients about WALANT.
- Chapter 43. Lalonde DH, Wong J, Phillips A, Jagodzinski NA. Complex reconstructions in hand surgery.
Published or accepted scientific papers:
- Preventable hand injuries: A national audit. Jennifer C.E. Lane, Anna Loch Wilkinson, Grey Giddins, Maxim D. Horwitz. + Collaborative authors including Nikolas A. Jagodzinski. JPRAS Open. Volume 38, December 2023, Pages 305-312
- BSSH/GIRFT National guidelines for operating outside an operating theatre - June 22.
- Health Economic evaluation of the impact of OrthoPathway in NHS Trusts - Independent evaluation report for SBRI Healthcare. Health Economics Consulting Group, Norwich Medical School, University of East Anglia. 10.6.21. I am acknowledged as a contributor to this report.
- Jagodzinski N and Falade M are collaborative authors on: Dean BJF on behalf of the SUSPECT study group. The management of suspected scaphoid fractures in the UK: a national cross-sectional study. Bone Jt Open 2021;2-11:997-1003.
- Nkala M, Das Y, Jagodzinski NA. Scaphoid fracture fixation using WALANT. Int J Health Sci Res 2019 Dec;9(12):166-168.
- Jagodzinski NA, Ibish S, Furniss D. Surgical site infection after hand surgery outside the operating theatre: a systematic review. J Hand Surg (Eur) 2017 Mar;42(3);289-94.
- Matthews A, Jagodzinski NA, Metcalfe JE, Westwood M, Trimble K. Effectiveness of the Cobb-Stainsby excision arthoplasty. Accepted Foot & Ankle 13/11/2016. Published online.
- Jagodzinski NA, Burge P. Re: Cousins GR et al. Arm versus forearm tourniquet for carpal tunnel decompression - which is better? A randomized controlled trial. J Hand Surg Eur. 2015, 40:961-965. J Hand Surg (Eur) 13.05.16. doi: 10.1177/1753193416632645
- Jagodzinski NA, Bevan L, McNab ISH. Intraosseous suture fixation of a sagittal distal phalanx fracture. J Hand Surg (Eur) Published Online First 13.4.2016 Vol. XXE(X) 1-2. doi: 10.1177/1753193415613983
- Phillips A, Jagodzinski NA. Wide Awake Hand Surgery (WAHS)? Ezine IFSSH 2014.5(1):6-8/2/15.
- Jagodzinski NA, Taylor, CF, Al-Shawi A. Case Report: Pyrophosphate arthroplasty for proximal capitate avascular necrosis. Hand 2015 Jun;10(2):239-42.
- Jagodzinski NA, Parsons A, Parsons S. Arthroscopic triple and modified double hindfoot arthrodesis. Foot and Ankle Surgery 2015 Jun;21(2):97-102.
- Phillips A, Jagodzinski NA, Cook G, Lalonde D. DVD: Wide awake hand surgery - techniques and business model. Winner of 2014 British Society for Surgery of the Hand Educational Video Prize for playing at BSSH spring meeting 2015 + for archiving in BSSH video library + on VuMedi
- Tendon sheath washout using a Buchanan's cholangiogram cannula. J Hand Surg Eur Vol 2014 Nov;39(9):1002-3.
- Jagodzinski NA, Davis N, Butler M, Parsons S. Arthroscopic resection of talocalcaneal coalitions - A bi-centre case series of a new technique. Foot Ankle Surg. June 2013;19(2):125-130.
- Jagodzinski NA, Fisher NE, Wright L, Prem H. Results of an effective Hub and Spoke model for the treatment of clubfoot. Ann R Coll Surg Eng (Bulletin) 2011.93(10):364 [DOI: 10.1308/147363511X594993]
- Jagodzinski NA, Bunker TT. A pioneering legacy - The Devas elbow replacement 31 years on. Shoulder Elbow 2011(Jan);3(1):49-51. Article first published online: 1 DEC 2010 | DOI: 10.1111/j.1758-5740.2010.00097.x
- Jagodzinski NA, Weerasinghe C, Porter K. Crush injuries and crush syndrome - A Review. Part 2: The local injury.Journal of Trauma. “Online First” DOI: 10.1177/1460408610372441 + in Trauma 2010(July);12(3):133-148.
- Jagodzinski NA, Weerasinghe C, Porter K. Crush injuries and crush syndrome - A Review. Part 1: The systemic injury. Journal of Trauma. “Online First” DOI: 10.1177/1460408610372440 + in Trauma 2010(April);12(2):69-88.
- Fisher NE, Killampalli VV, Kundra RK, Jagodzinski NA, Mathur K, Reading AD. Sporting and physical activity following hip resurfacing. Int Orthop 2011(Jul);35(7):977-80 DOI: 10.1007/s00264-010-1053-1.
- Jagodzinski NA, Begum R, Khanum S, Prem H. Day surgery for major paediatric foot and ankle procedures. J Orthop Surg 2011(April);19(1):69-71 (1022-5536;1022-5536). Also Abstracts published in J Bone Joint Surg Suppl + J One Day Surg 18(S.l) June 2008.
- Jagodzinski NA, Kanwar R, Graham KH, Bache CE. Prospective evaluation of a shortened regimen of treatment for acute osteomyelitis and septic arthritis in children. J Pediatr Orthop (Am) 2009(July-Aug);29(5):518-525. (0271-6798;1539-2570). Abstract also published in J Children's Orthop 2(S.1) March 2008.
Research In Progress:
- HAND-2 National RCT comparing needle fasciotomy and open fasciectomy for Dupuytren's Disease. Primary Investigator for RDHNHST.
- S. Ayeko, N Jagodzinski. What is the maximum safe duration of upper limb tourniquet use? - A systematic review.
- Jones M, Jagodzinski NA. The use of Orthopathways decision support software to streamline referrals, reduce face-to-face appointments and establish a one-stop surgery service for patients with Carpal Tunnel Syndrome.
- Gurung I, Das Y, Jagodzinski NA. A prospective randomised comparative audit of surgical site infection of hand surgery in a treatment room versus an operating theatre.
- Jagodzinski NA, Mishra A, Rodriguez J. An up-to-date systematic review on Surgical site infection after hand surgery outside the operating theatre. Completed and submitted for publication.
- Jugurnath P, Jagodzinski NA. Management of finger with embedded ring.
- Jagodzinski NA, Little C. Should cubital tunnel decompressions be done under local anaesthesia? I have designed a prospective series comparing WALANT vs GA vs RA.
- Kambiz S, Jagodzinski NA, Giele H. Linburg-Comstock anomaly release following trapeziectomy - Case Report.
- Jagodzinski NA. Does combining a segmental palmer fasciectomy with a needle fasciotomy delay Dupuytren's recurrence compared with either procedure performed alone?
- Jagodzinski NA, Milner Q. Wide awake volar plate fixation of distal radius fractures.
- Jagodzinski NA, Little C. Algorithm for management of PIP joint fracture dislocations.