Hand exam readiness
Document mechanism, time, handedness, location, depth, contamination, exposed structures, neurovascular exam, tendon function, imaging, and foreign-body concern.
Hand consult triage
Should I Consult Hand Surgery?
A concise triage aid for hand trauma, fight bite, tendon injury, flexor tenosynovitis concern, fractures, ischemia, and neurovascular findings.
Common Hand questions
Start With the Clinical Question
Before you consult
Make the Hand Question Answerable
Fight bite
Clarify whether the wound overlies the MCP joint, timing, ROM, swelling, imaging/foreign body, infection signs, and local bite pathway status.
Fracture or tendon injury
Bring open/closed status, rotation/alignment, neurovascular exam, tendon function, imaging, reduction/splint status, and follow-up feasibility.
Digital ischemia
Do not delay local emergency/vascular/trauma pathways when perfusion deficit, compartment concern, high-pressure injection, or vascular injury is plausible.
Use this when the question involves functional risk, tendon/nerve/vascular injury, deep infection, fight bite, open fracture, digital ischemia, or unstable fracture/dislocation.
Common low-yield consults
Usually Better as First-Step Workup or Local Pathway First
- Simple closed nondisplaced fractures with intact neurovascular exam and a clear local splint/follow-up pathway.
- Superficial lacerations with intact tendon, nerve, vascular, bone, joint, and foreign-body exam.
- Small paronychia/felon already addressed through local pathway with no deep-space, immune, or progression concern.
- Chronic hand pain or arthritis without acute injury, infection, neurovascular change, or functional emergency.
Copyable consult message
Hand Consult Dotphrase
Reason for Consult: *** Handedness / occupation or function-critical need: *** Mechanism and timing: *** Location / wound depth / contamination: *** Neurovascular exam: *** Motor / tendon exam: *** Imaging: *** Tetanus / antibiotics / irrigation status per local pathway: *** Reduction / splinting status if applicable: *** NPO status if operative concern: *** Clinical question: *** Callback: *** Thank you!
Best practices for Hand consults
- Include handedness, function-critical occupation, mechanism, timing, and exact wound/fracture location.
- Document perfusion, sensation distribution, motor/tendon function, and imaging before asking about disposition.
- For bites, specify MCP location, clenched-fist mechanism, contamination, foreign-body concern, and local bite pathway status.
- For fractures/dislocations, include open vs closed, rotation, alignment, stability, reduction/splint status, and neurovascular exam.
Hand consult patterns
High-Yield Hand Context
Deep infection
Flexor tenosynovitis concern, deep-space infection, rapidly progressive swelling, severe pain, or immunocompromise increases urgency of Hand discussion.
Fight bite
Dorsal MCP wounds after punching someone can involve joint/tendon structures and should be framed carefully.
Neurovascular or ischemic findings
Perfusion deficit, digital ischemia, compartment concern, high-pressure injection, or vascular injury can alter timing.
Tendon, nerve, fracture, or amputation
Exposed tendon/bone, open fracture, unstable fracture/dislocation, amputation, or loss of function is higher yield.
Hand consults FAQ
Common Hand Questions
What makes a Hand consult higher yield?
The most useful request identifies the specialty-specific decision, the local pathway already active, and the workup or first step already completed.
What should I avoid?
Avoid sending only a diagnosis label, lab result, or procedure name. Frame the decision Hand can change.
References
Educational tool only. SIC provides clinician-facing educational consult-triage references. SIC does not diagnose, treat, prevent, cure, or mitigate disease and is not a substitute for clinical judgment, local guidelines, institutional referral pathways, or recommendations from your hand surgery department. See disclaimer and how SIC works.