If any of the following are present or suspected, please refer the patient to the emergency department (via ambulance if necessary) or seek emergent medical advice if in a remote region.
The list below includes common traumatic injuries that require referral to emergency and should not be referred for elective / fracture clinic categorisation
- 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 Registrar on 3810 1111. For Neurosurgery and Spine conditions please call the Neurology or Spinal Registrar at The Princess Alexandra Hospital on 3176 2111
- 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 equina syndrome
- Bilateral nerve pain (leg pain below knees)
- Bladder / bowel dysfunction
- Perineal anaesthesia
- Progressive weakness
- Bone infection