Dr Maguire believes that most upper limb conditions can initially be treated non-operatively. Obviously there are some situations where patients should be "referred-on" early, particularly if a delay in surgery may lead to a sub-optimal result.
Below are some scenarios and conditions in the upper limb which Dr Maguire feels are best referred early to an Upper Limb Surgeon for an opinion regarding surgery.
SHOULDER
- Rotator Cuff Arthropathy
- Acute Rotator Cuff Tear
- Severe weakness with Rotator Cuff Tear
- Shoulder dislocation in young patient (less than 30)
- First time traumatic shoulder dislocation
- Widely displaced clavicle fractures
- Fractures of proximal humerus with displacement
- Concerns regarding joint infection
ELBOW
- Acute tennis elbow (trauma causing tear)
- All displaced fractures (particularly intra-articular)
- Distal biceps ruptures
- Cubital Tunnel Syndrome
- Concerns regarding joint infection
WRIST
- Scaphoid Fractures
- Wrist fractures (particularly if intra-articular)
- Acute ligament injuries (particularly complete tears)
- Carpal dislocations
- Carpal Tunnel Syndrome
- Concerns regarding joint infection
HAND
- Dislocations
- Trigger finger with locked digit
- Tendon ruptures or lacerations
- Infections with possible abscess formation
- Tooth Knuckle Injuries
- Concerns regarding joint infection