Ortho Emergencies

Immediate Hand Surgery Consultation Guidelines Delayed Hand Surgery Consultation Guidelines
Vascular injury with signs of tissue ischemia or poorly controlled hemorrhage Extensor/flexor tendon laceration (if not repaired in ED)
Irreducible dislocations Flexor digitorum profundus rupture (closed)
Grossly contaminated wounds Nerve injury (proximal to mid middle phalanx)
Severe crush injury Closed fractures
Open fracture Dislocations
Compartment syndrome Ligamentous injuries with instability
High pressure injection injury  
Hand/finger amputation  


Indication for Emergent Ankle or Foot Orthopedic intervention & injuries for Ortho referral:
Orthopedic Emergencies Orthopedic Referral (<72hrs)
Major Talar neck & body fracture Extra-articular calcaneal fracture
Intra-articular calcaneous fracture First metatarsal fracture
All open fractures Displaced metatarsal shaft
All fracture dislocation unstable Ligamentous injuries
Maisonneuve fractures with neurvascular compromise Stable unimalleolar fracture
Bimalleolar & trimalleolar fracture with neurovascular compromise Peroneal dislocation
Lisfranc Injuries Maisonneuve, bimalleolar, & trimalleolar fractures with good reduction, no neurovascular compromise, and ensured orthopedic follow-up
Compartment Syndrome Jone fracture.