Referral to emergency

If any of the following are present or suspected, please refer the patient to the emergency department (via ambulance if necessary) or seek emergent medical advice if in a remote region.

  • nil

For clinical advice, please telephone the relevant metropolitan Local Health Network switchboard and ask to speak to the relevant specialty service.

Central Adelaide Local Health Network

Southern Adelaide Local Health Network

Exclusions

  • Dupuytren’s nodules without functional impairment or contracture

Triage categories

Category 1 - appointment clinically indicated within 30 days

  • nil

Category 2 — appointment clinically indicated within 90 days

  • severe contracture resulting in skin ulceration
  • fixed flexion deformity causing proximal interphalangeal joint (PIPJ) contractures
  • multiple joint or contracture recurrence with functional impairment post-surgery
  • rapidly progressing contracture

Category 3 — appointment clinically indicated within 365 days

For more on outpatient referrals, see the general referral information.

Essential referral information

Completion required before first appointment to ensure patients are ready for care. Please indicate in the referral if the patient is unable to access mandatory tests or investigations as they incur a cost or are unavailable locally.

  • identifies as Aboriginal and/or Torres Strait Islander
  • relevant social history, including identifying if you feel your patient is from a vulnerable population and/or requires a third party to receive correspondence on their behalf
  • interpreter requirements
  • past medical/surgical history
  • current medications and dosages
  • allergies and sensitivities
  • presenting symptoms
  • management history including:
    • injury/trauma if relevant
    • onset and duration
    • severity
    • pain
    • associated features, e.g. functional impairment, range of motion (ROM)
    • treatments trialled/implemented prior to referral
  • plain X-ray wrist anterior-posterior (AP)/lateral views, include provider details and accession number

Clinical management advice

Please note that hand and wrist referrals can be managed by the following specialist services:

Hueston’s tabletop testing is the ability to flatten hands palms first onto a tabletop.

It is strongly recommended that people who smoke or vape stop 3 months prior to consultation. Smoking/vaping is associated with delayed healing. Please refer to useful resources section for further information.

Clinical resources

Consumer resources