Diagnosis | Specialty |
Cellulitis over a joint | Ortho |
Finger/metacarpal fractures | Plastics |
Scaphoid/carpal fractures | Ortho |
Necrotising fasciitis | Plastics |
Spinal injuries | Neurosurgery |
Suspected spine fractures | Ortho if neurosurgery don’t want them/until cross sectional imaging |
Hand/Wrist lacerations needing exploration | Plastics |
Antecubital fossa and axillary soft tissue injuries | Plastics/ortho depending on injured structures (early discussion at consultant level) |
Flexor/Extensor tendon injuries | Plastics |
Head injuries | See head injury pathway, not ortho |
Nail bed injury/paronychia of finger | Plastics |
Nail bed injury/paronychia of toe | Ortho |
Hair tourniquet syndrome | Plastics |
Suspected vascular injury | Plastics or paediatric surgery (see guideline) |
Lacerations over femoral triangle requiring exploration | Paediatric surgery, (low threshold for calling plastics if any suggestion of vascular injury, early discussion at consultant level) |
Suspected osteomyelitis/discitis | Ortho |
Suspected septic arthritis | Ortho |
RHC ED 'Who Takes What?' referrals - Orthopaedics/Plastics/Neurosurgery

Warning
Objectives
This page acts as a guide to which speciality, in general, admits which diagnoses in RHC. If there are any concerns or discussions which differ to the allocations below then discuss with ED senior.