How to refer to Hand Therapy
Inpatients
Inpatients are referred by EMR Hand Therapy Consult request. The census task list is checked in the morning and at midday. If there is an urgent referral please call Hand Therapy to flag this.
Post-op
Hand Therapy requests direct referral of post-op patients where specialised splinting and early movement are important for outcomes, for example post operative Tendon repairs, finger or metacarpal fracture ORIF and MCP joint arthroplasties. Idealy patients should be provided with an appointment prior to discharge.
Distal Radius Fractures
It is not uncommon for pain and oedema to occur following distal radius fracture whether treated non-operatively or operatively. Information regarding the signs and symptoms of common complications should be given along with a simple self-directed management plan. Patients should be provided with advice and education to manage pain and oedema, and to prevent loss of motion at the fingers, thumb, elbow and shoulder. Immobilisation casting should allow a full fist to be achieved with the fingers and the patient can be encouraged to use the injured limb whilst the wrist is immobilised for light functional activities, including self-care and tasks such as typing.
Patients who experience disproportionate levels of pain, oedema, loss of motion or delayed functional recovery should be referred to Hand Therapy after clinical assessment for further instruction and treatment (BSSH Best practice for management of Distal Radius Fractures. Published by British Orthopaedic Association and British Society for Surgery of the Hand 2018)
Consultant Hand Clinics
Hand Therapy attends the Plastics Consultant Hand Clinic and Orthopaedic Hand Clinics on Wednesdays. Please verbally refer patients to the Hand Physiotherapists in the Clinic and Hand Therapy documented in EMR constitues the referral.
Other Clinics
Call to discuss with the Hand Physiotherapists for urgent referrals. EMR referrals are accepted and patients can be direct booked by the Outpatient clerical staff into Hand Physiotherapy, this process can be triaged with the attending clinic Physiotherapists.
Compensable Patients/ Out of Area
POWH Hand Therapy can treat compensible patients where there is prolonged hospitalisation or the patient will continue to be manged through the POWH Outpatient Consultant Hand Clinics. If post op patients are being managed in Specialists Rooms or live out of area it is preferred that they start their treatment with a Private Practice or Local Service. The Australian Hand Therapy Association website has a find a therapist function to assist in locating a suitable service.
Advanced Musculoskeletal Physiotherapy Hand Clinic
AMPHC commenced in 2017 due to the unmanageable workload in Plastics and Orthopaedic Hand Clinics. Simple hand injuries such as mallet fingers, PIP dislocations and metacarpal neck fractures are referred directly from ED to Hand Therapy and managed there in their entirety. This Clinic has diverted hundreds of patients from the busy Consultant Hand Clinics. The clinic is run on Tuesday morning to facilitate referral to the Wednesday clinics without loss of time if there are any concerns. For further information see the AMPHC document in the resources section