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.

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.

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.

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

Back to top