Hand Surgery consult communication
How to Consult Hand Surgery
What to include when calling Hand Surgery about flexor tenosynovitis, fight bite, ischemia, tendon injury, fracture, dislocation, infection, or neurovascular concern.
Lead With the Decision
What hand function, tendon, nerve, vessel, infection, open injury, reduction, operative timing, or follow-up question do you need Hand Surgery to answer?
Not sure whether the consult is appropriate? Start with the Should I Consult Hand Surgery? triage page, then return here before calling.
Before the call
Have These Details Ready
- Mechanism, hand dominance, occupation/functional needs, time of injury, contamination, bite exposure, crush, high-pressure injection, or open fracture concern.
- Exact location by side, digit, zone if known, joint involvement, wound depth, exposed tendon/bone, and foreign body concern.
- Neurovascular exam: cap refill, pulse/bleeding, two-point discrimination or sensory distribution, motor function, tendon isolation, and range of motion.
- Imaging findings, reduction attempts, irrigation, antibiotics, tetanus, splinting, ring removal, and pain control.
- Specific ask: bedside repair, OR, urgent transfer, reduction help, admission, antibiotics, or clinic follow-up timing.
Exam focus
Document the Specialty-Relevant Exam
- Document handedness and affected hand/digit.
- Isolate FDP/FDS/extensor function when possible; describe cascade, malrotation, joint stability, and ROM limits.
- Cap refill, pulse/bleeding, temperature/color, sensation by nerve distribution or two-point discrimination if available.
- Kanavel signs, fight-bite location, deep-space infection signs, wounds crossing joints, and contamination.
Phone or secure-chat script
A Cleaner Hand Surgery Consult Message
I am calling about a [age]-year-old [right/left]-hand-dominant patient with [mechanism] involving [hand/digit/location]. Exam shows [vascular/sensory/motor/tendon/ROM/wound findings]. Imaging shows [fracture/dislocation/foreign body]. We have done [irrigation/antibiotics/tetanus/splint/reduction]. My question is [OR/bedside repair/reduction/transfer/admission/follow-up timing].
Common pitfalls
Avoid Low-Signal Consults
- Calling “hand lac” without tendon, nerve, vessel, joint, foreign body, and handedness details.
- Omitting hand dominance and functional context.
- Calling possible flexor tenosynovitis without documenting Kanavel-type findings and timing.
Reference links
Useful Background
Educational tools 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 the relevant specialty department. See disclaimer and how SIC works.