Mater Specialist Quick Find

Orthopaedic Surgery – public patients 

Purpose

This page contains information for general practitioners on how to refer patients aged 16 years and over to Orthopaedic services at Mater Hospital Brisbane

Service: 

Mater Hospital Brisbane’s Orthopaedic team specialises in referrals for sports injuries, including knee ligament problems, primary and revision lower limb joint replacement surgery, foot and ankle conditions, shoulder conditions and general orthopaedic conditions for patients 16 years and over.

Our multidisciplinary team includes Orthopaedic surgeons, Fellows, Training Registrars, Service Manager, Clinical Nurse Consultant, and Allied Health. Many patients will have their care assessed and managed by our Clinical Nurse Consultant and Physiotherapy led clinics. Our service has excellent outpatient waiting times, with all patients receiving care within their allocated urgency Category of 1, 2 or 3.

The Orthoapedic service is also an integral member of the Multidisciplinary High Risk Foot Service, which comprises of medical specialists (from Diabetes and Endocrine, Orthopaedics and Vascular), wound nurses, podiatrists and clinical nurses who collaboarate at a fortnightly clinic to develop individualised plans of care. 

With a dedicated research coordinator, the Orthopaedics department leads and contributes to a range of research projects to ensure our care continues to be of the highest safety and quality and at the forefront of innovation. 

How to Refer: 

If referral for care is indicated please list all of the General Referral Information and reason for request, and essential information as indicated below.

To refer, please fill in the Mater Adult Referral Form, available to download and embed into most major Practice Management software applications.

Referrals can be sent by:

Secure messaging  Medical Objects:   HM4101000R8
  HealthLink EDI:    materref   
Fax    07 3163 8548

 

 

 

 

Emergency 

If any of the following are present or suspected, phone 000 to arrange immediate transfer to the emergency department or seek emergency medical advice if in a remote region:

 

View list of conditions:

  • Acute cervical myelopathy
  • Acute back or neck pain secondary to neoplastic disease or infection
  • Spinal injuries
  • Suspected open fracture
  • Fracture requiring manipulation or operation
  • Suspected acute bone or joint infection
  • Acute high energy fracture with/without neurological abnormality
  • Injury associated with vascular compromise
  • Clavicle fracture
  • Osteoporotic / pathological fracture new abnormal neurology
  • Suspected infection or sudden pain in arthroplasty
  • if joint infection is suspected refer immediately to emergency or contact the orthopaedic registrar on call
  • do not commence antibiotics unless delay to specialist review is likely
  • Joint dislocations
  • Open injuries with possible tendon or joint involved
  • Nail bed injuries or retained foreign body
  • Knee extensor mechanism rupture
  • Acute peripheral nerve injury
  • Suspected acute compartment syndrome
  • Spine, Neck, Back Pain NB: contact the Orthopaedic/Neurosurgery/Spine Registrar on-call for advice.
  • High risk of irreversible deficit if not assessed urgently
  • Spinal infections
  • Significant spinal nerve root compression or spinal cord compression with progressive neurological signs/symptoms e.g.
    • spinal cord compression with severe or rapidly progressing neurological deficit
    • cauda equine syndrome
      • bilateral nerve pain (leg pain below knees)
      • bladder / bowel dysfunction
      • perineal anaesthesia
      • progressive weakness
  • bone infection

 

Scope of Service

Conditions out of scope

The following conditions are not routinely provided at Mater Hospital Brisbane:

View list of conditions:

  • Aesthetic or cosmetic surgery
  • Spinal surgery e.g. any spinal pathology that may require surgery - Please refer to the Mater Centre for Neurosciences
  • Complex fingers and hands e.g. all conditions below the carpus, arthritis, tumour, ligament injury, tendon injury, 1st CMC arthritis - Please refer to the Mater Plastics and Reconstructive Surgery Service
  • Complex wrist e.g. arthritis, scapholunate ligament injury, scapholunate advanced collapsed (SLAC) wrist, scaphoid non-union advanced collapse (SNAC), Kienboch’s disease - please refer to your local HHS
  • Complex elbow e.g. instability, arthritis - please refer to your local HHS
  • Complex forearm e.g. radial/ulna club hand, malunion of radius/ulna, radial/ulna/median nerve injuries and requiring tendon transfers - please refer to your local HHS
  • Orthopaedic Oncology - please refer to your local HHS

 

Conditions in scope

Foot and Ankle - Achilles Tendon Pathology and Rupture

Essential information (Referral will be declined without this)

  • General referral information
  • History of:
  • symptoms
  • rate of deterioration of the condition
  • Aggravating and relieving factors
  • Pain assessment –waking up at night, analgesic consumption
  • Interference with activities of daily living and working ability
  • Neurological deficit
  • Weight bearing x-rays
  • USS for any tendinopathy (not required for Achilles rupture if examination confirms)

Additional referral information (useful for processing the referral)

  • Management to date (including insoles and physiotherapy)
  • High risk foot clinic or podiatrist reports

Other useful information for management (not an exhaustive list)

Management:

  • Analgesia/NSAIDs as appropriate
  • Physiotherapy/podiatry (where available)
  • Heel cups/heel raise (where available)
  • Abstention from activities that caused the symptoms
  • Backslab or moon boot for acute or suspected achilles tendon rupture. Review in fracture clinic.
  • Chronic disease requires to be optimized prior to referral or the patients may not proceed to surgery

Categorisation

Available appointments are provided to our patients based on clinical priority. A process of categorisation ensures safety and equity of access.

Category 1 – urgent

Clinically recommended timeframe for initial appointment is 30 days

Category 2 - Priority

Clinically recommended timeframe for initial appointment is 90 days

Category 3 - Routine

Clinically recommended timeframe for initial appointment is 365 days

Refer directly to emergency or fracture clinic if clinically indicated:

  • acute achilles tendon rupture
  • if delayed presentation of achilles tendon rupture (>6 weeks)

 

A tender, nodular swelling

Functional impairment and/or  pain persists despite maximal management

 

Foot and Ankle - Arthritis

Essential information (Referral will be declined without this)

  • General referral information
  • History of:
  • symptoms
  • rate of deterioration of the condition
  • Pain assessment –waking up at night, analgesic consumption, aggravating and relieving factors
  • Interference with activities of daily living and working ability
  • Nerve irritation signs (Tinels foot sign or hyperaesthesia)
  • Neurological deficit
  • XR results  - AP and lateral ankle/foot including weight bearing/standing views

Additional referral information (useful for processing the referral)

  • Management to date (including insoles and physiotherapy)
  • High risk foot clinic or podiatrist reports

Other useful information for management (not an exhaustive list)

Management

  • Analgesia/NSAIDs as appropriate
  • Consider steroid injection as appropriate
  • Physiotherapy
  • Podiatry
  • Mobility aid and activity modification
  • Footwear advice/walking aids (where available)
  • Therapeutic massage
  • Obesity is associated with an increase in complications associated with surgery – consider dietitian & weight reduction monitoring if BMI is a concern
  • Chronic disease requires to be optimized prior to referral or the patients may not proceed to surgery

Categorisation

Available appointments are provided to our patients based on clinical priority. A process of categorisation ensures safety and equity of access.

Category 1 – urgent

Clinically recommended timeframe for initial appointment is 30 days

Category 2 - Priority

Clinically recommended timeframe for initial appointment is 90 days

Category 3 - Routine

Clinically recommended timeframe for initial appointment is 365 days

Refer directly to emergency if clinically indicated e.g. suspected septic arthritis

Skin ulceration secondary to deformity or pressure

 

Presence of avascular necrosis

Associated with diabetic peripheral neuropathy

Functional impairment and/or  pain persists despite maximal management, such as physiotherapy or managed weight loss

 

 

Foot and Ankle - Heel Pain

Essential information (Referral will be declined without this)

  • General referral information
  • History of:
  • symptoms
  • rate of deterioration of the condition
  • Aggravating and relieving factors
  • Pain assessment – waking up at night, analgesic consumption
  • Interference with activities of daily living and working ability
  • Nerve irritation signs (Tinels foot sign or hyperaesthesia)
  • Neurological deficit
  • XR results - AP and lateral ankle/foot including weight bearing/standing views

Additional referral information (useful for processing the referral)

  • Management to date (including insoles and physiotherapy)
  • High risk foot clinic or podiatrist reports (if available)

Other useful information for management (not an exhaustive list)

Management

  • Analgesia/NSAIDs as appropriate 
  • NB: Ibuprofen is effective in the ‘reactive’ (acute/acute-on-chronic) stage of tendinopathy
  • Steroid injections for plantar fasciitis under the trigger point
  • Physiotherapy/podiatry (where available)
  • Footwear advice/walking aids e.g. modification footwear/heel cups/heel raise (where available)
  • Chronic disease requires to be optimized prior to referral or the patients may not proceed to surgery

Categorisation

Available appointments are provided to our patients based on clinical priority. A process of categorisation ensures safety and equity of access.

Category 1 – urgent

Clinically recommended timeframe for initial appointment is 30 days

Category 2 - Priority

Clinically recommended timeframe for initial appointment is 90 days

Category 3 - Routine

Clinically recommended timeframe for initial appointment is 365 days

Refer directly to fracture clinic,  where available, if associated with:

  • trauma
  • infection
  • ulceration
  • suspected fracture

If associated with diabetic peripheral neuropathy

Functional impairment and/or  pain persists despite maximal management

 

Heel and Foot - Pain / Deformity in Forefoot and Hind Foot

Essential information (Referral will be declined without this)

  • General referral information
  • History of:
  • symptoms
  • rate of deterioration of the condition
  • Aggravating and relieving factors
  • Pain assessment –waking up at night, analgesic consumption
  • Interference with activities of daily living and working ability
  • Neurological deficit
  • Nerve irritation signs
  • XR results - AP and lateral ankle/foot including weight bearing/standing views

Additional referral information (useful for processing the referral)

  • Management to date (including insoles and physiotherapy)\
  • High risk foot clinic or podiatrist reports

Other useful information for management (not an exhaustive list)

The Mater offers a collaborative multidisciplinary high risk foot service for diabetic patients who have been assessed as having or developing foot complications. This may be an appropriate alternate referral pathway for your patient

Management

  • Analgesia/NSAIDs as appropriate
  • Check tibialis posterior
  • Footwear advice/walking aids e.g. modification footwear/arch supports
  • Physiotherapy/podiatry (where available)
  • Orthoses (where available)
  • Consider USS- guided steroid injection for Morton’s neuroma / intermetatarsal bursa (as appropriate)
  • Obesity is associated with an increase in complications associated with surgery – consider dietitian & weight reduction monitoring if BMI is a concern
  • Chronic disease requires to be optimized prior to referral or the patients may not proceed to surgery

Categorisation

Available appointments are provided to our patients based on clinical priority. A process of categorisation ensures safety and equity of access.

Category 1 – urgent

Clinically recommended timeframe for initial appointment is 30 days

Category 2 - Priority

Clinically recommended timeframe for initial appointment is 90 days

Category 3 - Routine

Clinically recommended timeframe for initial appointment is 365 days

Refer directly to fracture clinic if associated with:

  • trauma
  • infection
  • ulceration/threatened ulceration

suspected fracture

 

If associated with diabetic or other progressive neuropathy (consider a referral to Mater High Risk Foot Service as an alternate pathway) 

Functional impairment and pain persists despite maximal management

 

 

Hip and Knee - Hip Pain

Essential information (Referral will be declined without this)

  • General referral information
  • History of:
  • symptoms, length and severity of symptoms / degree of disability/ability/mobility
  • recurrent infections
  • previous infection related to referred joint 
  • Previous joint surgery (THR/TKR)
  • Height, weight and BMI
  • Examination for ROM and fixed deformity
  • Is the condition stable or how quickly has it deteriorated?
  • Details of functional impairment. Level of ability to do daily activities/walking distance/ability to put on shoes.
  • XR results - AP pelvis AP affected hip showing proximal 2/3 femur and lateral affected hip.  Instruct patient to bring imaging films/results to clinic appointment.
  • FBC ESR CRP results

Additional referral information (useful for processing the referral)

Other useful information for management (not an exhaustive list)

Management

  • Analgesia/NSAIDs as appropriate
  • Physiotherapy/hydrotherapy (where available)
  • Mobility aid and activity modification (i.e. use of a walking aid contralateral hand)
  • Remain active as pain allows (get moving program/home exercise program)
  • Home modification and use of adult day care
  • Better health self-management program
  • Obesity is associated with an increase in complications associated with surgery – consider dietitian & weight reduction monitoring if BMI > 35
  • Chronic disease requires to be optimized prior to referral or the patients may not proceed to surgery

Categorisation

Available appointments are provided to our patients based on clinical priority. A process of categorisation ensures safety and equity of access.

Category 1 – urgent

Clinically recommended timeframe for initial appointment is 30 days

Category 2 - Priority

Clinically recommended timeframe for initial appointment is 90 days

Category 3 - Routine

Clinically recommended timeframe for initial appointment is 365 days

Refer directly to emergency if clinically indicated e.g. suspected septic arthritis

Radiological evidence of avascular necrosis of hip in a patient <60 years

History of trauma / falls

 

 

 

 

 

Severe symptoms impairing quality of life, based on:

  • pain and/or disability
  • sleep disturbancerelating to mobility/independence
  • inability to undertake normal activities
  • reduced functional capacity or psychiatric illness
  • unresponsive to therapy over ≥ 2 months

Gradual onset pain in previously well-functioning arthroplasty

Radiological evidence of avascular necrosis of hip > 60 years of age

Young adult <40 years suspected labral tear with acute mechanism and mechanical symptoms

Functional impairment and/or pain persists despite maximal management

 

Hip and Knee - Knee Pain (Acute)

Essential information (Referral will be declined without this)

  • General referral information
  • History of:
  • symptoms
  • date
  • recurrence of injury and mechanism
  • severity or evolution of injury
  • Pain and other symptoms including haemarthrosis / effusion, locking, instability
  • True locking (versus intermittent stiffness)
  • XR results - knee weight bearing AP, lateral and skyline. 

Additional referral information (useful for processing the referral)

Other useful information for management (not an exhaustive list)

  • Timing of first review appointments at orthopaedic outpatients:
  • If there is documentation indicating adequate alignment and satisfactory initial treatment of fracture – to be seen within 14 days of referral
  • All other fracture cases, delayed presentation of tendon and nerve injuries - to be seen within 7 days of referral
  • For suspected infection of native or prosthetic knee do not start antibiotics until discussed with on call registrar. If systemic illness associated then refer direct to ED.

Management

  • XR to rule out fracture
  • Analgesia/anti-inflammatories/ NSAIDs as appropriate
  • Physiotherapy/hydrotherapy (where available)
  • Mobility aid and activity modification
  • Remain active as pain allows (get moving program/home exercise program)
  • Home modification and use of adult day care
  • Better health self-management program
  • Obesity is associated with an increase in complications associated with surgery – consider dietitian & weight reduction monitoring if BMI > 35

Categorisation

Available appointments are provided to our patients based on clinical priority. A process of categorisation ensures safety and equity of access.

Category 1 – urgent

Clinically recommended timeframe for initial appointment is 30 days

Category 2 - Priority

Clinically recommended timeframe for initial appointment is 90 days

Category 3 - Routine

Clinically recommended timeframe for initial appointment is 365 days

Refer directly to emergency if clinically indicated:

  • suspected septic arthritis
  • acute extensor mechanism rupture
  • XR demonstrates fracture

Locked knee

Significant internal or ligamentous derangement

 

Identified:

  • post traumatic instability
  • meniscal injuries (without degeneration)
  • effusion

Unstable patella

Avascular necrosis of the tibial plateau

Functional impairment and/or pain persists despite maximal management

 

Hip and Knee - Knee Pain (Chronic)

Essential information (Referral will be declined without this)

  • General referral information
  • History of:
  • symptoms
  • date
  • recurrence of injury and mechanism
  • severity or evolution of injury
  • recurring infections
  • Pain and other symptoms including effusion, locking, instability
  • Previous joint surgery
  • True locking (vs intermittent stiffness)
  • Results of clinical ligament and meniscus tests if completed
  • Height, weight and BMI
  • XR results - knee, weight bearing AP, lateral and skyline of both knees
  • Investigations for inflammatory arthropathy

Additional referral information (useful for processing the referral)

Other useful information for management (not an exhaustive list)

Management

  • Analgesia/NSAIDs as appropriate
  • Avoid steroid injection
  • Physiotherapy/hydrotherapy (where available)
  • Mobility aid and activity modification/gait aid
  • Remain active as pain allows (get moving program/home exercise program)
  • Home modification and use of adult day care
  • Better health self-management program
  • Obesity is associated with an increase in complications associated with surgery – consider dietitian & weight reduction monitoring if BMI .35. Mandatory for BMI >40
  • Chronic disease requires to be optimized prior to referral or the patients may not proceed to surgery
  • Osteoarthritis of the knee clinical care standard https://www.safetyandquality.gov.au/wp-content/uploads/2017/05/Osteoarthritis-of-the-Knee-Clinical-Care-Standard-Booklet.pdf

Categorisation

Available appointments are provided to our patients based on clinical priority. A process of categorisation ensures safety and equity of access.

Category 1 – urgent

Clinically recommended timeframe for initial appointment is 30 days

Category 2 - Priority

Clinically recommended timeframe for initial appointment is 90 days

Category 3 - Routine

Clinically recommended timeframe for initial appointment is 365 days

Refer directly to emergency if:

  • evidence of acute inflammation eg.
    • haemarthrosis
    • tense effusion

 

 

Symptoms rapidly deteriorating and causing severe disability

Pain in previously well-functioning arthroplasty

Some functional impairment and/or pain persists despite maximal management

 

 

 

Shoulder and Elbow

Essential information (Referral will be declined without this)

  • General referral information
  • History of symptoms – including duration, recurrence of injury and mechanism, severity or evolution of injury
  • Arm ROM with any neurological examination/signs
  • XR results - AP & lateral shoulder/elbow
  • USS results if suspected rotator cuff pathology

Additional referral information (useful for processing the referral)

  • Management to date
  • Physiotherapy assessment report
  • According to clinical suspicion
  • CT/MRI results
  • According to clinical suspicion
  • protein electrophoresis
  • immunoglobulins
  • calcium and phosphate
  • rheumatoid serology
  • If inflammation/ infection suspected
  • FBC ESR CRP results

Other useful information for management (not an exhaustive list)

Management

  • Shoulder rehabilitation program
  • Advice to avoid dislocation (recurrent)
  • Activity modification
  • Physiotherapy
  • Analgesia/NSAIDs as appropriate
  • Consider corticosteroid injection for:
    • rotator cuff tendinopathy
    • AC joint pain
    • frozen shoulder where pain predominates (early stages)
    • shoulder OA if patient is unwilling/unsuitable for surgical management
    • sub-acromial impingement

Categorisation

Available appointments are provided to our patients based on clinical priority. A process of categorisation ensures safety and equity of access.

Category 1 – urgent

Clinically recommended timeframe for initial appointment is 30 days

Category 2 - Priority

Clinically recommended timeframe for initial appointment is 90 days

Category 3 - Routine

Clinically recommended timeframe for initial appointment is 365 days

Refer directly to emergency if:

  • clinically indicated e.g. suspected septic arthritis
  • evidence of acute inflammation, e.g:
    • haemarthrosis
    • tense effusion

First episode of dislocation in adults > 40 years old 

 

 

 

 

 

First episode of shoulder dislocation in a patient <25 years old

Recurrent dislocated shoulder/shoulder instability

Instability associated with structural pathology in a patient <40 years old e.g. SLAP lesion, large Bankart lesion

History of trauma suggests acute event / tear (rather than degenerative) rotator cuff tear

 

Functional impairment and/or pain of shoulder/elbow and failed maximal medical management

AC joint conditions

Chronic weakness and degenerative rotator cuff

Rotator cuff tendinopathy

  • sub-acromial impingement

Pain/stiffness in elbow not responding to maximal medical management

Elbow tendonitis

Shoulder adhesive capsulitis (frozen shoulder)

 

Spine / Neck / Back Pain

At the Mater Hospital Brisbane this condition is managed by the Neurosurgery Service Please refer to their referral guidelines and name the referral to their head of department. 

Trauma and Fractures - Hand Trauma

At the Mater Hospital Brisbane this condition is managed by the Plastics and Reconstructive Surgery Service. Please refer to their referral guidelines and name the referral to their head of department.

Trauma and Fracture - Lower Limb Trauma (also see Acute Knee Pain above)

Essential information (Referral will be declined without this)

  • General referral information
  • History of:
  • symptoms
  • date
  • time
  • mechanism
  • severity or evolution of injury
  • Management to date (immobiliser, splint, cast etc.)
  • XR results - Instruct patient to bring imaging films/results to clinic appointment

Additional referral information (useful for processing the referral)

  • No additional information

Other useful information for management (not an exhaustive list)

  • Timing of first review appointments at orthopaedic outpatient’s/fracture clinic
  • if there is documentation indicating adequate alignment and satisfactory initial treatment of fracture – to be seen within 14 days of referral
  • all other fracture cases, delayed presentation of tendon and nerve injuries - to be seen within 7 days of referral
  • Do not delay referral for open, unstable fractures — refer to emergency or contact the orthopaedic registrar on-call.
  • Please refer early as treatment may change with a delayed referral
  • Chronic disease requires to be optimized prior to referral or the patients may not proceed to surgery
  • Management
  • Assess and document neurovascular status
  • Check XR post manipulation (if applicable)
  • Immobilise fractured limb in a sling, shoulder immobiliser or cast as appropriate

Categorisation

Available appointments are provided to our patients based on clinical priority. A process of categorisation ensures safety and equity of access.

Category 1 – urgent

Clinically recommended timeframe for initial appointment is 30 days

Category 2 - Priority

Clinically recommended timeframe for initial appointment is 90 days

Category 3 - Routine

Clinically recommended timeframe for initial appointment is 365 days

Undisplaced fracture

Fracture that have been reduced satisfactorily

Delayed presentation nerve or tendon injury

Delayed presentation joint dislocation

 

Fracture delayed or non-union

Mal-union affecting function

Mal-union not affecting function

 

Trauma and Fracture - Spinal Fracture (acute osteopathic / pathologic fracture not requiring admission for pain relief)

At the Mater Hospital Brisbane this condition is managed by the Neurosurgery Service Please refer to their referral guidelines and name the referral to their head of department. 

Trauma and Fractures - Upper Limb Trauma

Essential information (Referral will be declined without this)

  • General referral information
  • Previous orthopaedic conditions and operations
  • History of:
  • symptoms
  • date
  •  time
  • mechanism
  • severity or evolution of injury
  • Treatment to date (Immobiliser, splint or cast etc.)
  • Other joint involvement
  • XR results - scaphoid views only if out of plaster.  Instruct patient to bring imaging films/results to clinic appointment

Additional referral information (useful for processing the referral)

  • No additional information

Other useful information for management (not an exhaustive list)

  • Timing of first review appointments at orthopaedic outpatient’s/fracture clinic
  • if there is documentation indicating adequate alignment and satisfactory initial treatment of fracture – to be seen within 14 days of referral
  • all other fracture cases, delayed presentation of tendon and nerve injuries - to be seen within 7 days of referral
  • Do not delay referral for open, unstable fractures — refer to emergency or contact the orthopaedic registrar on-call.
  • Please refer early as treatment may change with a delayed referral
  • Chronic disease requires to be optimized prior to referral or the patients may not proceed to surgery

Management

  • Assess and document neurovascular status
  • Check XR post manipulation (if applicable)
  • Immobilise fractured limb in a sling, shoulder immobiliser or cast as appropriate

Categorisation

Available appointments are provided to our patients based on clinical priority. A process of categorisation ensures safety and equity of access.

Category 1 – urgent

Clinically recommended timeframe for initial appointment is 30 days

Category 2 - Priority

Clinically recommended timeframe for initial appointment is 90 days

Category 3 - Routine

Clinically recommended timeframe for initial appointment is 365 days

Undisplaced fracture

Fracture that have been reduced satisfactorily

Delayed presentation nerve or tendon injury

Delayed presentation joint dislocation

 

Fracture delayed or non-union

Mal-union affecting function

 

Mal-union not affecting function

 

Wrist and Hand - Basal Thumb Arthritis

At the Mater Hospital Brisbane this condition is managed by the Plastics and Reconstructive Surgery Service. Please refer to their referral guidelines and name the referral to their head of department.

Wrist and Hand - Dupuytren's Contracture

At the Mater Hospital Brisbane this condition is managed by the Plastics and Reconstructive Surgery Service . Please refer to their referral guidelines and name the referral to their head of department. 

Wrist and Hand - Ganglia

Essential information (Referral will be declined without this)

Additional referral information (useful for processing the referral)

  • Management to date
  • USS results (for clarification of presence of cyst)

Other useful information for management (not an exhaustive list)

Management

Categorisation

Available appointments are provided to our patients based on clinical priority. A process of categorisation ensures safety and equity of access.

Category 1 – urgent

Clinically recommended timeframe for initial appointment is 30 days

Category 2 - Priority

Clinically recommended timeframe for initial appointment is 90 days

Category 3 - Routine

Clinically recommended timeframe for initial appointment is 365 days

If concerned that lump may be infective

 

No category 2 criteria

Symptomatic or enlarging ganglion of the wrist/hand not suitable for primary health management 

 

Wrist and Hand - Painful / Stiff Wrist

Essential information (Referral will be declined without this)

  • General referral information
  • History of fall or trauma
  • XR results - AP and lateral wrist. (Consider scaphoid views). Instruct patient to bring imaging films/results to clinic appointment.

Additional referral information (useful for processing the referral)

  • Management to date
  • Results for Investigations for inflammatory arthropathy
  • FBC ESR & CRP results if inflammation is suspected

Other useful information for management (not an exhaustive list)

Management

  • Analgesia/NSAIDs as appropriate
  • Trial of wrist splint and activity modification
  • Occupational therapy/physiotherapy
  • Consider infection, inflammatory and crystal arthropathies as well as arthritis
  • History of trauma / falls– see ‘upper limb trauma criteria’
  • History of inflammatory disease – consider referral to rheumatology
  • Chronic disease requires to be optimized prior to referral or the patients may not proceed to surgery

Categorisation

Available appointments are provided to our patients based on clinical priority. A process of categorisation ensures safety and equity of access.

Category 1 – urgent

Clinically recommended timeframe for initial appointment is 30 days

Category 2 - Priority

Clinically recommended timeframe for initial appointment is 90 days

Category 3 - Routine

Clinically recommended timeframe for initial appointment is 365 days

Refer directly to emergency if clinically indicated e.g. suspected septic arthritis

History of trauma – consider upper limb trauma criteria

 

Rapid deterioration in function

History of inflammatory disease – consider referral to rheumatology

Abnormal XR or painful/stiff wrist not responding to maximal management

 

Wrist and Hand - Stenosing Tenosynovitis

Essential information (Referral will be declined without this)

  • General referral information
  • Management to date
  • Describe chronicity
  • Determine if there is normal passive ROM in the MP, PIP, and DIP joints

Additional referral information (useful for processing the referral)

  • USS results

Other useful information for management (not an exhaustive list)

  • Management
  • Analgesia/NSAIDs (as appropriate)
  • Consider steroid injection as appropriate
  • Occupational therapy/physiotherapy to maintain mobility/ prevent stiffness and contracture/maintain extension/prevent/control pain/strengthening
  • Chronic disease requires to be optimized prior to referral or the patients may not proceed to surgery

Categorisation

Available appointments are provided to our patients based on clinical priority. A process of categorisation ensures safety and equity of access.

Category 1 – urgent

Clinically recommended timeframe for initial appointment is 30 days

Category 2 - Priority

Clinically recommended timeframe for initial appointment is 90 days

Category 3 - Routine

Clinically recommended timeframe for initial appointment is 365 days

Newly fixed trigger finger

 

 

 

 

 

Chronic fixed trigger finger

Stenosing tenosynovitis suggested by 1 or more of the following symptoms:

  • stiffness
  • locking
  • tenderness
  • painful clicking >6 months

Failed maximal management including one steroid injection and splints

Intermittent trigger finger / stenosing tenosynovitis persists

 

 

Wrist and Hand - Upper Limb Nerve Compression

Essential information (Referral will be declined without this)

Additional referral information (useful for processing the referral)

  • XR results - AP and lateral (of region) (if available)
  • Nerve conduction studies (where available and not cause significant delay)

Other useful information for management (not an exhaustive list)

Management

  • Analgesia/NSAIDs as appropriate
  • Consider steroid injection (e.g. carpal tunnel syndrome) if clinically appropriate
  • Night splint (e.g. carpal tunnel syndrome)
  • Occupational therapy / physiotherapy - for splinting, joint ROM exercises to maintain mobility, neural gliding exercises
  • Chronic disease requires to be optimized prior to referral or the patients may not proceed to surgery

Categorisation

Available appointments are provided to our patients based on clinical priority. A process of categorisation ensures safety and equity of access.

Category 1 – urgent

Clinically recommended timeframe for initial appointment is 30 days

Category 2 - Priority

Clinically recommended timeframe for initial appointment is 90 days

Category 3 - Routine

Clinically recommended timeframe for initial appointment is 365 days

Refer directly to emergency if:

  • upper limb radiculopathy in the presence of suspected cervical spine infection
  • upper limb nerve compression in association with trauma or acute event

 

Continuous pain and / or muscle weakness in distribution of peripheral upper limb nerve

Recurrent symptoms after surgical decompression

Rapid progressive deterioration

 

Intermittent symptoms without weakness or wasting in distribution of peripheral upper limb nerve

Carpal tunnel syndrome refer after 6 months of maximal management

Ulnar entrapment neuropathy when no response to ≥ 6 months of maximal management

 

 

Other Orthopaedic Surgery Condition

Essential information (Referral will be declined without this)

Categorisation

Available appointments are provided to our patients based on clinical priority. A process of categorisation ensures safety and equity of access.

Category 1 – urgent

Clinically recommended timeframe for initial appointment is 30 days

Category 2 - Priority

Clinically recommended timeframe for initial appointment is 90 days

Category 3 - Routine

Clinically recommended timeframe for initial appointment is 365 days

 

Our Specialists 

Dr John Radovanovic

Director of Orthopaedics

Dr David Bade

Orthopaedic Surgeon

Dr Benjamin Forster

Orthopaedic Surgeon

Dr Ashish Gupta

Orthopaedic Surgeon

Dr Simon Journeaux

Orthopaedic Surgeon

Dr Michael Lutz

Orthopaedic Surgeon

Dr Tim McMeniman

Orthopaedic Surgeon

Dr Peter Myers

Orthopaedic Surgeon

Dr Tony O'Neill

Orthopaedic Surgeon

Dr Anubhav Sathu

Orthopaedic Surgeon

Dr Bjorn Smith

Orthopaedic Surgeon

Dr John Walsh

Director of Paediatric Orthopaedics

 

Foot and Ankle Fellow

 

Sports Medicine Fellow 

 

Athroplasty Fellow

 

Training Registrar

 

Primary House Officers (PHOs)


Bulk Billed Clinics

Mater Health offers patients the opportunity to attend bulk billed clinics. To provide your patient with the opportunity to attend a bulk billed clinic, please provide a named referral to one of the specialists listed above.

Contact Us 

If you would like to discuss a referral, including clinical criteria, or update the status of a current patient please contact our priority GP phone line on 07 3163 2200 

Current Waiting Time for Appointments 

We provide up to date data on how long patients are waiting for their first appointment by specialty here.

Referral Guideline Development

These Mater Referral Guidelines align with standardised best practice tools for referral to publicly funded specialist outpatient services developed in Queensland through the Clinical Prioritisation Criteria project. 

 

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