Orthopaedics
Conditions
Please note this is not an exhaustive list of all conditions for outpatient services and does not exclude consideration for referral unless specifically stipulated in the out of scope section.
- Achilles tendon pathology and rupture adult
- Arthritis of hand and/or wrist adult
- Back and/or Neck Pain adult
- Back Pain paediatric
- Benign Tumours of the Hand and Wrist adult
- Bow legs paediatric
- Carpal Tunnel Syndrome/Cubital Tunnel Syndrome adult
- Club foot/feet/inversion (Talipes Equinovarus) paediatric
- Developmental dysplasia of the hip (DDH) paediatric
- Dupuytren’s contracture adult
- Elbow conditions adult
- Foot and ankle conditions associated with diabetic foot disease adult
- Foot and ankle pain and/or deformity (non-diabetic) adult
- Hand trauma adult
- Heel pain paediatric
- Hip pain adult
- In-toeing paediatric
- Knee injury (acute) adult
- Knee pain (chronic) adult
- Knock knees paediatric
- Limping child/reluctant to weight bear paediatric
- Lower limb trauma adult
- Osgood-Schlatter disease paediatric
- Out-toeing paediatric
- Perthes disease paediatric
- Scoliosis / Kyphosis paediatric
- Shoulder instability adult
- Shoulder pain adult
- Slipped upper femoral epiphysis (SUFE) paediatric
- Stenosis tenosynovitis conditions adult
- Toe-walking paediatric
- Tumour – bone and soft tissue paediatric
- Upper limb trauma adult
Paediatric services
Referrals for children and young people should follow the Children’s Health Queensland referral guidelines.
Orthopaedic Paediatric services are delivered on behalf of MNHHS at Redcliffe Hospital for people residing in the catchment area.
- Achilles tendon pathology and rupture adult
- Arthritis of hand and/or wrist adult
- Back and/or Neck Pain adult
- Back Pain paediatric
- Benign Tumours of the Hand and Wrist adult
- Bow legs paediatric
- Carpal Tunnel Syndrome/Cubital Tunnel Syndrome adult
- Club foot/feet/inversion (Talipes Equinovarus) paediatric
- Developmental dysplasia of the hip (DDH) paediatric
- Dupuytren’s contracture adult
- Elbow conditions adult
- Foot and ankle conditions associated with diabetic foot disease adult
- Foot and ankle pain and/or deformity (non-diabetic) adult
- Hand trauma adult
- Heel pain paediatric
- Hip pain adult
- In-toeing paediatric
- Knee injury (acute) adult
- Knee pain (chronic) adult
- Knock knees paediatric
- Limping child/reluctant to weight bear paediatric
- Lower limb trauma adult
- Osgood-Schlatter disease paediatric
- Out-toeing paediatric
- Perthes disease paediatric
- Scoliosis / Kyphosis paediatric
- Shoulder instability adult
- Shoulder pain adult
- Slipped upper femoral epiphysis (SUFE) paediatric
- Stenosis tenosynovitis conditions adult
- Toe-walking paediatric
- Tumour – bone and soft tissue paediatric
- Upper limb trauma adult
Emergency department referrals
All urgent cases must be discussed with the on call Registrar to obtain appropriate prioritisation and treatment. Contact through:
- Royal Brisbane and Women's Hospital (07) 3646 8111
- The Prince Charles Hospital (07) 3139 4000
- Redcliffe Hospital (07) 3883 7777
- Caboolture Hospital (07) 5433 8888
Urgent cases accepted via phone must be accompanied with a written referral and a copy faxed immediately to the Central Patient Intake Unit: 1300 364 952.
If any of the following are present or suspected, please refer the patient to the emergency department (via ambulance if necessary):
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
- Irreducible glenohumeral dislocation with or without fracture
- Upper limb vascular compromise
- Elbow conditions - Dislocation with or without fracture
- Elbow conditions - Trauma with acute neurological or vascular compromise
Wrist and hand
- Uncontrolled sepsis including hand infections
- Upper limb radiculopathy in the presence of suspected cervical spine infection
- Acute development of peripheral nerve compression symptoms following trauma or acute event
- Suspected flexor sheath infection
- Suspected Septic arthritis
Bone & Soft Tumour
- Suspected malignancy
Hip and knee
- Suspected septic arthritis
- Knee extensor mechanism rupture
- 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.
- if joint infection is suspected refer immediately to emergency or contact the orthopaedic registrar on call.
Foot and ankle
- Suspected septic arthritis
- Infected diabetic ulceration (systemic signs/symptoms)
- Displaced fracture of the ankle or hindfoot
- Acute achilles tendon rupture (if no fracture clinic available)
- Avulsion fracture of achilles tendon from calcaneus
Back and/or Neck Pain
- Cauda equina syndrome
- High energy spinal trauma
- Suspected epidural abscess or discitis
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
- Open 'tooth knuckle' injury
Upper and lower limb trauma
- Open, unstable or suspected fractures
Other referrals to emergency not covered within these conditions
- 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
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
Limping child/reluctant to weight bear
- Limping child with signs of:
- Being unwell, flushed, lethargic, fever, flat, anorexic and/or
- Irritable and stiff joint and/or
- Not improving
- Systemically unwell, febrile or suspicion of septic arthritis
- Concern of infection or trauma
- Suspicion or concern of non-accidental injury
NB See Slipped upper femoral epiphysis (SUFE) CPC
Heel Pain
- Systemically unwell, febrile or suspicion of septic arthritis
- Concern of infection or trauma
- Suspicion or concern of non-accidental injury
Osgood-Schlatter Disease
- Suspected infection or bone disease
Perthes Disease
- For guidelines regarding when to refer to emergency, please see HealthPathways.
- Systemically unwell, febrile or suspicion of septic arthritis
- Concern of infection or trauma
Slipped upper femoral epiphysis (SUFE)
- All suspected or confirmed SUFE should be referred to the ED or local orthopaedic on call registrar service no matter the chronicity
Scoliosis / Kyphosis / Back pain
- Systemically unwell
- Abnormal neurological reason
Tumour – bone and soft tissue
- Suspected malignancy
Infection: bone/joint
- If clinically confirmed or suspected bone infection who present with;
- fever
- unexplained limp and/or abnormal posture or gait
- reluctance to use the limb or will not weight bear if lower limb affected
- musculoskeletal pain ± presence of local bone or joint tenderness, swelling or erythema
- complete or partial limitation of movement on examination.
- All cases with pain, or abnormal labs or abnormal bone scan
Out of scope services
Not all services are funded in the Queensland public health system. The following are not routinely provided in a public Orthopeadic service.
- Aesthetic or cosmetic surgery
- Disability assessment (refer to HealthPathways)
- Referrals for assessment prior to application for the Australian Defence Force or Queensland Police service
Clinic details
Royal Brisbane and Womens Hospital
Level 7, Ned Hanlon Building
The Prince Charles Hospital
Ground floor, Main Building
Redcliffe Hospital
Ground floor, Main Building
Specialists list
Send referral
Hotline: 1300 364 938
Medical Objects ID: MQ40290004P
HealthLink EDI: qldmnhhs
Mail:
Metro North Central Patient Intake
Aspley Community Centre
776 Zillmere Road
ASPLEY QLD 4034
Health pathways
Access to Health Pathways is free for clinicians in Metro North Brisbane.
For login details email:
healthpathways@brisbanenorthphn.org.au
Login to Brisbane North Health Pathways:
brisbanenorth.healthpathwayscommunity.org