Note: all referrals from non-UHB hospitals need to be assessed by the local trauma and orthopaedics (T&O) or plastics team first.
Birmingham Heartlands Hospital (UHB)
Amputation | Yes |
---|---|
Devascularised finger | Yes |
Brachial artery/forearm or arm vessel injury |
Involve vascular |
Acute flexor tendon injury | Yes |
Acute extensor tendon injury | Yes |
Digital nerve injury | Yes |
Nail bed injury | Yes |
Acute phalangeal fractures | Only if needs surgery |
Acute metacarpal fractures | Only if needs surgery |
Acute distal radius fractures | Discuss duty consultant |
Acute scaphpoid fractures | Only if needs surgery |
Acute other carpal fractures | Only if needs surgery |
Malunions / Nonunions / >4 weeks old fracture |
No - elective referral |
Flexor sheath infections | Yes |
Forearm / Arm wounds without tendon / nerve injury |
Yes |
UL abscess proximal to wrist | No - T&O |
UL abscess distal to wrist | Discuss duty consultant |
Cellulitis proximal to the wrist | No - medics |
Septic arthritis of the wrist | No - T&O |
Paronychia | Yes if cannot be treated in A&E |
Phalangeal dislocations | Only if needs surgery - reduce in A&E first |
Good Hope Hospital (UHB)
Amputation | Yes |
---|---|
Devascularised finger | Yes |
Brachial artery/forearm or arm vessel injury |
Involve vascular |
Acute flexor tendon injury | Yes |
Acute extensor tendon injury | Yes |
Digital nerve injury | Yes |
Nail bed injury | Yes |
Acute phalangeal fractures | Only if needs surgery |
Acute metacarpal fractures | Only if needs surgery |
Acute distal radius fractures | Discuss duty consultant |
Acute scaphpoid fractures | Only if needs surgery |
Acute other carpal fractures | Only if needs surgery |
Malunions / Nonunions / >4 weeks old fracture |
No - elective referral |
Flexor sheath infections | Yes |
Forearm / Arm wounds without tendon / nerve injury |
Yes |
UL abscess proximal to wrist | No - T&O |
UL abscess distal to wrist | Discuss duty consultant |
Cellulitis proximal to the wrist | No - medics |
Septic arthritis of the wrist | No - T&O |
Paronychia | Yes if cannot be treated in A&E |
Phalangeal dislocations | Only if needs surgery - reduce in A&E first |
City and Sandwell
Amputation | Yes |
---|---|
Devascularised finger | Yes |
Brachial artery/forearm or arm vessel injury |
Refer to vascular |
Acute flexor tendon injury | No |
Acute extensor tendon injury | No |
Digital nerve injury | No |
Nail bed injury | No |
Acute phalangeal fractures | No |
Acute metacarpal fractures | No |
Acute distal radius fractures | No |
Acute scaphpoid fractures | No |
Acute other carpal fractures | No |
Malunions / Nonunions / >4 weeks old fracture |
No |
Flexor sheath infections | No |
Forearm / Arm wounds without tendon / nerve injury |
No |
UL abscess proximal to wrist | No |
UL abscess distal to wrist | No |
Cellulitis proximal to the wrist | No |
Septic arthritis of the wrist | No |
Paronychia | No |
Phalangeal dislocations | No |
Russels Hall - Dudley
Amputation | Yes |
---|---|
Devascularised finger | Yes |
Brachial artery/forearm or arm vessel injury |
Refer to vascular |
Acute flexor tendon injury | Yes |
Acute extensor tendon injury | Yes |
Digital nerve injury | Yes |
Nail bed injury | No |
Acute phalangeal fractures | No |
Acute metacarpal fractures | No |
Acute distal radius fractures | No |
Acute scaphpoid fractures | No |
Acute other carpal fractures | No |
Malunions / Nonunions / >4 weeks old fracture |
No |
Flexor sheath infections | Yes |
Forearm / Arm wounds without tendon / nerve injury |
No |
UL abscess proximal to wrist | No |
UL abscess distal to wrist | Discuss duty consultant |
Cellulitis proximal to the wrist | No |
Septic arthritis of the wrist | No |
Paronychia | No |
Phalangeal dislocations | No |
Walsall Manor
Amputation | Yes |
---|---|
Devascularised finger | Yes |
Brachial artery/forearm or arm vessel injury |
Refer to vascular |
Acute flexor tendon injury | Yes |
Acute extensor tendon injury | Yes |
Digital nerve injury | Yes |
Nail bed injury | No |
Acute phalangeal fractures | No |
Acute metacarpal fractures | No |
Acute distal radius fractures | No |
Acute scaphpoid fractures | No |
Acute other carpal fractures | No |
Malunions / Nonunions / >4 weeks old fracture |
No |
Flexor sheath infections | Yes |
Forearm / Arm wounds without tendon / nerve injury |
No |
UL abscess proximal to wrist | No |
UL abscess distal to wrist | Discuss duty consultant |
Cellulitis proximal to the wrist | No |
Septic arthritis of the wrist | No |
Paronychia | No |
Phalangeal dislocations | No |
Wolverhampton
Amputation | Yes |
---|---|
Devascularised finger | Yes |
Brachial artery/forearm or arm vessel injury |
Refer to vascular |
Acute flexor tendon injury | Yes |
Acute extensor tendon injury | Yes |
Digital nerve injury | Yes |
Nail bed injury | No |
Acute phalangeal fractures | No |
Acute metacarpal fractures | No |
Acute distal radius fractures | No |
Acute scaphpoid fractures | No |
Acute other carpal fractures | No |
Malunions / Nonunions / >4 weeks old fracture |
No |
Flexor sheath infections | Yes |
Forearm / Arm wounds without tendon / nerve injury |
No |
UL abscess proximal to wrist | No |
UL abscess distal to wrist | Discuss duty consultant |
Cellulitis proximal to the wrist | No |
Septic arthritis of the wrist | No |
Paronychia | No |
Phalangeal dislocations | No |
Worcester
Amputation | Yes |
---|---|
Devascularised finger | Yes |
Brachial artery/forearm or arm vessel injury |
Refer to vascular |
Acute flexor tendon injury | Yes |
Acute extensor tendon injury | Yes |
Digital nerve injury | Yes |
Nail bed injury | No |
Acute phalangeal fractures | No |
Acute metacarpal fractures | No |
Acute distal radius fractures | No |
Acute scaphpoid fractures | No |
Acute other carpal fractures | No |
Malunions / Nonunions / >4 weeks old fracture |
No |
Flexor sheath infections | Yes |
Forearm / Arm wounds without tendon / nerve injury |
No |
UL abscess proximal to wrist | No |
UL abscess distal to wrist | Discuss duty consultant |
Cellulitis proximal to the wrist | No |
Septic arthritis of the wrist | No |
Paronychia | No |
Phalangeal dislocations | No |
Redditch
Amputation | Yes |
---|---|
Devascularised finger | Yes |
Brachial artery/forearm or arm vessel injury |
Refer to vascular |
Acute flexor tendon injury | Yes |
Acute extensor tendon injury | Yes |
Digital nerve injury | Yes |
Nail bed injury | No |
Acute phalangeal fractures | No |
Acute metacarpal fractures | No |
Acute distal radius fractures | No |
Acute scaphpoid fractures | No |
Acute other carpal fractures | No |
Malunions / Nonunions / >4 weeks old fracture |
No |
Flexor sheath infections | Yes |
Forearm / Arm wounds without tendon / nerve injury |
No |
UL abscess proximal to wrist | No |
UL abscess distal to wrist | Discuss duty consultant |
Cellulitis proximal to the wrist | No |
Septic arthritis of the wrist | No |
Paronychia | No |
Phalangeal dislocations | No |
Other hospitals
Amputation | No |
---|---|
Devascularised finger | No |
Brachial artery/forearm or arm vessel injury |
No |
Acute flexor tendon injury | No |
Acute extensor tendon injury | No |
Digital nerve injury | No |
Nail bed injury | No |
Acute phalangeal fractures | No |
Acute metacarpal fractures | No |
Acute distal radius fractures | No |
Acute scaphpoid fractures | No |
Acute other carpal fractures | No |
Malunions / Nonunions / >4 weeks old fracture |
No |
Flexor sheath infections | No |
Forearm / Arm wounds without tendon / nerve injury |
No |
UL abscess proximal to wrist | No |
UL abscess distal to wrist | No |
Cellulitis proximal to the wrist | No |
Septic arthritis of the wrist | No |
Paronychia | No |
Phalangeal dislocations | No |
Last reviewed: 26 January 2024