First and foremost, I'm a children's orthopaedic surgeon. I look after children mainly with hip conditions and broken bones at Alder Hey Children's Hospital — usually Perthes' disease and hip dysplasia. It's the children and families I meet in clinic who drive everything else that I do. There are different profiles of mine scattered across the internet — papers, talks, research — and this website is an attempt to stitch it together.
A diagnosis like Perthes' disease or hip dysplasia can be frightening for a family. Looking after those children well — reassuring parents, and getting the treatment right for that particular child — is the part of the job that matters most to me. The research that I do exists to make that care better. It grew out of something that really bothered me in clinic: the same child could be treated differently from one hospital to the next — in the UK or anywhere in the world — with little or no evidence for which approach was right.
Given the lack of evidence, it became a mission to build a research culture among the UK's children's surgeons and emergency teams — this has been embraced by so many forward-thinking clinicians throughout the UK (and now the rest of the world). That community is now TOTS — a huge team game, with the success belonging to many people, largely from the BSCOS and PERUKI organisations. The trials only happen because of the surgeons, ED doctors, nurses, physiotherapists and research teams recruiting in hospitals right across the UK (and increasingly across the world), and the children and families who agree to take part. The credit belongs to everyone who takes part — and I'm very grateful to each of them.
In terms of my background, I trained in Liverpool and Warwick, undertook a fellowship at SickKids in Toronto, and worked at Oxford's Kadoorie Institute — where I became a Fellow of Wolfson College — before returning to Liverpool as the first orthopaedic surgeon to hold an NIHR Research Professorship. More recently I completed Harvard Business School's year-long Program for Leadership Development.
“So much of what we do in surgery (especially children's surgery) has never been put to the test. Our job is to find out what genuinely helps — to stop the things that don't, and to make sure children get the treatments that do.”
A lot of children's orthopaedic surgery evolved without the robust research that other parts of medicine take for granted. Together we go after the everyday decisions where habit has quietly got ahead of the evidence.
FORCE asked whether a child with a buckle fracture of the wrist actually needs a rigid cast and a string of hospital visits. A soft bandage and going straight home did just as well — and families much preferred it. And it changed real-world care fast: use of the simpler approach in UK children's emergency departments rose from under 2% before the trial to a majority afterwards.
SCIENCE put an operation head-to-head with simple non-surgical care for children with a displaced type of elbow fracture called a medial epicondyle fracture. For most of them, surgery added risk and cost without adding benefit.
CRAFFT took badly displaced wrist fractures — the kind that would usually head to theatre — and asked whether a cast would do. In most children it did, thanks to a remarkable superpower in children — the ability to heal straight as they grow, called remodelling.
Almost all of this runs through TOTS — the Trauma, Orthopaedic and Emergency Trials in Children Collaborative, which brings together children's surgeons (through BSCOS) and emergency teams (through PERUKI) across the UK, with partners in North America, New Zealand and Australia. I'm chief investigator on many of the trials below; every one of them depends on that network.
Perthes' has stayed with me since it was the subject of my PhD. Around the world, children with it are still treated in very different ways — and that variation is exactly the kind of uncertainty only a proper trial can end. It's why I want OpNonSTOP, our trial of surgery versus non-surgical care for Perthes', to succeed as much as anything I've worked on.
The question is the same whether we're testing an operation, a diagnostic test or an AI tool: does it improve care, and is the evidence strong enough to change practice? Alongside trials, I lead a growing programme building and testing artificial intelligence for children's orthopaedic care — tools that do a real job.
Right now that means HIPPO, an NIHR-funded programme teaching machines to read hip X-rays so monitoring hip disease in children with cerebral palsy is faster and more reliable; automated detection of hip dysplasia in babies, working with Oxford's Department of Computer Science and industry partners; and a broader children's AI programme at Alder Hey. As with the trials, the interesting part isn't the algorithm — it's proving, carefully, that it actually helps a child.
Reading hip X-rays automatically, so children with cerebral palsy are watched more consistently and clinicians spend less time.
Automated detection of developmental hip dysplasia, working with Oxford's Department of Computer Science and industry partners.
A broader effort at Alder Hey to build and evaluate AI tools that genuinely earn a place in children's care.
A lot of my time goes into the systems that make good research possible for everyone, not just my own studies — and into supervising a gaggle of PhD students, which is one of the best parts of the job.
Chairing the prioritisation of national health research — helping decide what the NHS funds next.
National Specialty Lead for Orthopaedic Clinical Trials.
Specialty Editor for Paediatrics.
National Clinical Lead for the newborn and infant hip screening programme.
Always keen to hear about new research ideas, how to test and implement cool technology or just good questions in children's orthopaedics — especially from surgeons, emergency teams and units thinking about joining a study to help solve difficult questions for families.
D.C.Perry@liverpool.ac.ukI also take on a small number of selected medicolegal cases — enquiries are handled via McCollum Consultants.