Tom Wadsworth was one of the leading orthopaedic surgeons of his generation. He was born on 13 January 1930 in Liverpool, the son of Samuel Bertram Wadsworth and Elizabeth Brown. He was the youngest of four children and, being 14 years junior to the rest, had relatively old parents. His birth was difficult, his mother nearly dying of septicaemia. Thus, even at this early age, he was beginning to demonstrate that he was capable of being awkward. His mother received one of the first treatments of prontosil, survived, and lived to be nearly 100. His uncle Tom and brother George were physicians in Liverpool. Tom entered Liverpool University Medical School as a dental student. Nevertheless, by the end of his first year, he calculated that medicine was likely to be more profitable in the long term, and switched courses. After qualifying, he began to train as a cardiologist, but altered course to orthopaedics, because, it is said, of the influence of his grandfather, who had to have a leg amputated after an industrial accident. Tom became orthopaedic registrar at the Infirmary under Henry O'Mally, and set about obtaining Fellowships of the Royal Colleges of Surgeons of both England and Edinburgh, and a masters degree in orthopaedic surgery from the University of Liverpool. He was appointed as an orthopaedic surgeon at St Leonard's Hospital in the East End, and was appointed to the Hackney Hospital in 1966, joining the staff of St Bartholomew's Hospital after the creation of the City and Hackney Health District. Having trained with Al Swanson in the USA, he specialised in hand surgery, where he made substantial contributions. He developed various prosthetic devices, including a bi-cortical screw fixation for the olecranon and popularised the posterolateral approach to the elbow joint using a triceps tendon release technique. His early studies on the chromosomal abnormalities that are linked with the carrying angle of the elbow joint led to later research on the cubital tunnel syndrome and the resultant compression neuropathy of the ulnar nerve. As well as papers on these and other areas of interest, he wrote several chapters for textbooks, and in 1982 produced the first edition of his classic treatise *The elbow* which was published by Churchill Livingstone. At the time of his death he was preparing the second edition of his textbook, together with a companion surgical atlas. In his later years, as his diabetic retinopathy progressed, he expanded his medico-legal practice and in 1994 gained a legal qualification to support these activities. Until his sight deteriorated, he had been an avid reader of detective novels and spoke of writing one himself, claiming that he would have no difficulty in creating characters for the plot based on professional colleagues, some of whom were capable of the crimes and others he would gladly write up as the victims. He had been briefly married. He died on 8 February 2002.