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Reconstructive hand surgery


Minimum Referral Criteria

  • Category 1
    (appointment within 30 calendar days)
    • Severe/disabling symptoms of nerve compression and/or muscle weakness or wasting and NCS confirmation of diagnosis
    • Soft tissue tumour of the hand with suspicion of malignancy
  • Category 2
    (appointment within 90 calendar days)
    • Frequent symptoms of nerve compression and any of the following:
      • rapid progression
      • recurrence after surgical decompression
      • failed maximal medical management (refer to Healthpathways)
    • Major impacts on ADLs and/or employment
  • Category 3
    (appointment within 365 calendar days)
    • Secondary hand surgery after injury
    • Stenosing tenosynovitis and failed medical management
    • Rheumatoid hand deformity with impaired function or pain and failed maximal medical management
    • Symptomatic or enlarging ganglion of the hand

1. Reason for request Indicate on the referral

  • To establish a diagnosis
  • For treatment or intervention
  • For advice and management
  • For specialist to take over management
  • Reassurance for GP/second opinion
  • For a specified test/investigation the GP can't order, or the patient can't afford or access
  • Reassurance for the patient/family
  • For other reason (e.g. rapidly accelerating disease progression)
  • Clinical judgement indicates a referral for specialist review is necessary

2. Essential referral information Referral will be returned without this

  • History of handedness, occupation, significant hobbies and anticoagulant therapy
  • Smoking status
  • Medical management to date (include Allied health input and steroid injections)
  • Detailed clinical examination with sensory mapping and functional assessment (include impacts on ADL and employment)
  • Comprehensive neurovascular assessment
  • Details of functional impairment
  • XR for confirmed or suspected fracture or rheumatoid hand deformity
  • NCS required for Cat 1 cases only
  • Hand USS for stenosising tenosynovitis and soft tissue tumours of the hand

3. Additional referral information Useful for processing the referral

  • Occupational therapy/physiotherapy report
  • Nerve conduction studies if referred for nerve compression syndromes or nerve palsies

4. Request

Last updated: 13 June 2023