Mater Private Specialist Quick Find

Orthopaedics - public patients

Clinical Lead - Dr John Radovanovic

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.

Catchment criteria applies for referrals for this service. Patient referrals from outside the Mater SEQ Catchment (which includes Metro South and West Moreton Hospital and Health Services) may not be accepted.

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.

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 send a referral

                         

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:

  • The list below includes common traumatic injuries that require referral to emergency and should not be referred for elective / fracture clinic categorisation

    Shoulder and elbow conditions

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

    Wrist and hand

    • Suspected septic arthritis
    • Upper limb radiculopathy in the presence of suspected cervical spine infection
    • Acute development of peripheral nerve compression symptoms following trauma or acute event

    Hip and knee

    • Suspected septic arthritis
    • Knee extensor mechanism rupture
    • Suspected fracture
    • Evidence of acute inflammation for example
      • haemarthrosis
      • tense effusion
    • 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

    Foot and ankle

    • Suspected septic arthritis
    • Acute achilles tendon rupture

    Spine

    • If any of the following are present or suspected, refer the patient to the emergency department (via ambulance if necessary) or seek emergent medical advice if in a remote region.
    • Actual or threatened cauda equina syndrome
      • bilateral nerve pain (leg pain below knees)
      • unexplained or unexpected loss of bladder or bowel function
      • perineal anaesthesia
      • progressive weakness
    • Spinal tumour with significant pain and/or neurological deficit
    • Clinical signs spinal nerve root compression or spinal cord compression with rapidly progressive neurological signs/symptoms
    • Spinal trauma with significant pain and/or neurological deficit
    • Spinal fractures demonstrated on imaging
    • Clinical suspicion of spinal infections
    • High risk of irreversible deficit if not assessed urgently

    Trauma and fractures

    • 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
    • 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

    Hand trauma

    • Acute ligament injury
    • Tendon rupture
    • Compound ‘tooth knuckle’ injury

    Upper and lower limb trauma

    • Open, unstable or suspected fractures

    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

 

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
  • Disability assessment (refer to HealthPathwyas)
  • Referrals for assessment prior to application for the Australian Defence Force or Queensland Police Service
  • Spinal surgery e.g. any spinal pathology that may require surgery - Please refer to the Mater Neurosciences Centre Brisbane
  • 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
  • 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)

  • Refer to HealthPathways or local guidelines
  • 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

Acute achilles tendon rupture (may be seen in emergency or fracture clinic depending on local service)

If delayed presentation of achilles tendon rupture (>3 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)

  • refer to Healthpathways or local Guidelines
  • Obesity is associated with an increase in complications associated with surgery- consider dietitian and 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

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)

  • Refer to HealthPathways or local guidelines
  • 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

Suspected Malignancy

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. Referrals to this service are managed through the Diabetes and Endocrine pathway.

  • Refer to HealthPathways or local guidelines
  • 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

Suspected Malignancy

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 e.g. details of functional impairment. Level of ability to do daily activities/waking
  • recurrent infections (related to referred joint) 
  • Smoking status
  • HbA1C (diabetic patient referral only)
  • FBC, ESR, CRP results (if indicated by medical history)
  • Previous joint surgery (THR/TKR)
  • Height, weight and BMI
  • Examination for ROM and fixed deformity
  • Harris Hip Score 
  • XR results - AP pelvis AP affected hip showing proximal 2/3 femur and lateral affected hip.  

Additional referral information (useful for processing the referral)

  • MRI results if avascular necrosis is suspected (where available and not cause significant delay)

Other useful information for management (not an exhaustive list)

  • Refer to HealthPathways or local guidelines
  • Consider pre‐operative optimisation of patient with diagnosed and undiagnosed diabetes, prior to referral
  • Consider pre-operative optimisation of anaemia, as defined by a haemoglobin of < 13.0g/dL in men and 12.0g/dL in women, prior to referral
  • Smoking is a contraindication to hip and knee arthroplasty surgery
  • Better health self-management program
  • Obesity is associated with an increase in complications associated with surgery – consider dietitian & weight reduction if BMI is >35
  • Chronic disease requires to be optimised prior to referral or the patients may not proceed to surgery
  • Young adult <40 years suspected labral tear with acute mechanism and mechanical symptoms refer allied health care

Clinical resources

 

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

Past History or suspicion of malignancy

History of trauma/falls

 

 

 

 

 

Gradual onset pain in previously well-functioning arthroplasty

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

 

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)

  • Refer to HealthPathways or local guidelines
  • 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.
  • Chronic disease requires to be optimized prior to referral or the patients may not proceed to surgery
  • Obesity is associated with an increase in complications associated with surgery – consider dietitian & weight reduction monitoring if BMI is >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

Acute obstructed/Locked knee (unable to reach full extension)

Multi Ligament knee injury

 

 

Knee pain Identified:

  • post traumatic instability
  • effusion

Unstable patella

 

Meniscal injuries (in the absence of locking)

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: pain, true locking, instability, swelling, recurring infections
  • Injury details (if any): date, mechanism, severity, recurrence and evolution of injury
  • Smoking status
  • HbA1C (diabetic patient referral only)
  • FBC, ESR, CRP results (if indicated by medical history)
  • Previous joint surgery
  • 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

Additional referral information (useful for processing the referral)

Other useful information for management (not an exhaustive list)

Clinical resources

Patient resources

  • Refer to HealthPathways or local guidelines
  • Consider pre‐operative optimisation of patient with diagnosed and undiagnosed diabetes, prior to referral
  • Consider pre-operative optimisation of anaemia, as defined by a haemoglobin of < 13.0g/dL in men and 12.0g/dL in women, prior to referral
  • Smoking is a contraindication to hip and knee arthroplasty surgery
  • 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 optimised 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

Suspected Malignancy

New Pain in previously well-functioning arthroplasty 

 

 

Symptoms rapidly deteriorating and causing severe disability

 

Some functional impairment and/or pain persists despite maximal management

 

 

 

Shoulder and Elbow (Service suspended)

**Please note Mater is not accepting referrals for Elbow conditions. Please refer to your local HHS or consider private options.

 

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
  •  
  • Neurovascular examination (Cat 1 only)
  • 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
  • Refer to HealthPathways or local guidelines

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
  • Neurovascular examination (Cat 1 only)
  • 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)

  • Refer to HealthPathways or local guidelines
  • 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

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

Other useful information for management (not an exhaustive list)

  • Refer to HealthPathways or local guidelines

Clinical resources

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 malignant or infective

 

No category 2 criteria

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

  • symptomatic
  • causing concern
  • enlarging

 

Wrist and Hand - Painful / Stiff Wrist

** Please note Mater does not accept referrals for complex wrist conditions - see out of scope section above.

 

Essential information (Referral will be declined without this)

  • General referral information
  • History of fall or trauma
  • Functional assessment (ROM)
  • 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
  • FBC ESR & CRP results if inflammation is suspected

Other useful information for management (not an exhaustive list)

  • Refer to HealthPathways or local guidelines
  • 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

History of trauma – consider upper limb trauma criteria

Rapid deterioration in function

 

No Category 2 criteria

Painful/stiff wrist >3 months

 

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)

  • No additional information

Other useful information for management (not an exhaustive list)

  • Refer to HealthPathways or local guidelines
  • 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 (peripheral entrapment neuropathies)

Essential information (Referral will be declined without this)

  • General referral information
  • Detailed clinical examination with sensory mapping, presence of neurological deficit and functional assessment (include impacts on ADL and employment)
  • Management to date (include allied health input and steroid injections)
  • Duration and rate of progression of symptoms
  • Nerve Conduction Studies (NCS) required for Cat 1 cases only (where available and does not cause significant delay to patient accessing outpatient service)
  • CT spine (only where suspecting central compression pathology)

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)
  • OT/Physio report when available

Other useful information for management (not an exhaustive list)
 

  • Refer to Healthpathways or local guidelines
  • CTS can be referred to the following specialities but will be triaged in a unified manner by all specialities concerned:
    • Orthopaedics
    • Plastic and Reconstructive surgery
    • Neurosurgery
    • General Surgery
  • 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

  • Upper limb radiculopathy in the presence of suspected cervical spine pathology/malignancy
  • Severe disabling symptoms with weakness and wasting and NCS confirmation of diagnosis
  • Common peroneal nerve injury

 

Very frequent/continuous symptoms without weakness or wasting and any one of:
 

  • Rapid progressive deterioration
  • Recurrence after surgical decompression
  • Failed maximum medical management (refer Healthpathways)

 

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

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

 

 

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. 

 

Content last reviewed : 13 December 2023

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