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.
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
- Flinders Medical Centre (08) 8204 5511
- Dupuytren’s nodules without functional impairment or contracture
Category 1 - appointment clinically indicated within 30 days
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
- flexion contractures of metacarpophalangeal joint (MCPJ) failing Hueston’s tabletop test (refer to Clinical management advice and resources)
- functional impairment
For information on referral forms and how to import them, please view 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
- identify within your referral 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
- 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:
- plastics and reconstructive surgery.
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.
- Therapeutic Guidelines - Limb Conditions
- Royal Australian College for General Practitioners - Hands, Fingers, Thumbs Assessment and Management of Common Hand Injuries in General Practice
- Central Adelaide Local Health Network – PreHab: Getting Ready for Surgery