Orthopaedics – Fracture and Elective Orthopaedics

For Patients and Visitors:

What is the Orthopaedic Service?

The Northern Health Orthopaedic Service provides care for people with conditions affecting joints and bones of the upper and lower limbs. This may be in an Emergency setting, such as fracture following a fall, or for a long-standing condition such as osteoarthritis of the knee.

Patients are seen and treated at both Northern Hospital and Broadmeadows Hospital.

How to refer to the service

A referral is required.  Please visit your GP clinic, or present to the Emergency Department if the matter is urgent.

What can I expect from the service?

As a patient you can expect to be fully assessed, and any tests needed are arranged. A decision is then made as to whether surgery is required, or non-surgical treatment such as physiotherapy.

Patients with a new fracture or injury can expect to be seen by a doctor in the Fracture Clinic. From here, surgery, plastering or other treatments can be arranged.

With longer-standing conditions, you can expect to be given an Orthopaedic Clinic appointment, or in the case of Hip or Knee Osteoarthritis, a Physiotherapy Screening Clinic appointment; you will see a doctor or a physiotherapist, and a decision will be made as to whether surgery, non-surgical treatment, or further investigation is required.

A care plan will be made during your Clinic visit. This will be communicated with your GP either via a letter, or by being given a copy of your patient notes.

If you do require surgery, the appropriate paperwork will be completed. Following your surgery you can expect to be followed up in the Clinic until your recovery is complete.

If you do not require surgery, this information and any treatment required will be communicated to your GP.

What do I bring/need for my appointment?

  • It is important to bring along any Xrays or Scans if they were arranged by your GP; any Xrays or other tests done within the hospital will be available for the doctor to see
  • A list of current medications
  • Any information you may have relating to previous treatment of your condition
  • Medicare Card

 Contact Us

Phone:      8405 8335

Email:       SpecialistClinics@nh.org.au

Simple Fracture Diversion

Many patients who have a broken bone (‘Fracture’) do not need to see an Orthopaedic doctor for management. Northern Health has partnered with the Eastern Metropolitan Primary Health Network to provide extra training for GPs in the area to manage simple fractures.

Click here to download the patient information sheet

The following GP’s have been trained by our Orthopaedic department to manage these injuries:

A map of these sites is available via this link

You may  provide feedback via email to: fracture.diversion@nh.org.au

 

For Health Professionals:

Service Overview

The Northern Hospital Orthopaedic Service provides care for both Acute / Traumatic conditions such as recent fractures, via the Fracture Clinic, and for longstanding / chronic conditions via the Orthopaedic Clinic.

When a patient has been assessed and surgery deemed necessary, this is organised via the Outpatient Clinic. Some patients will require further investigation or Pre-Admission assessment, prior to surgery.

Many patients referred do not require, or do not wish to have, surgery. In this case we aim to provide a detailed summary outlining any treatment such as physiotherapy or bracing, which is required so that care can continue in the Community.

Inclusion criteria:

Fracture Clinic:

  • Fractures of upper or lower limb, excluding metacarpals
  • Acute ligament or tendon injuries such as Achilles Tendon
  • Locked knee

Orthopaedic Clinic:

  • Osteoarthritis – all joints of the upper and lower limb, excluding fingers
  • Shoulder conditions –rotator cuff pathology, instability, pain/stiffness
  • Elbow conditions – pain/stiffness/locking
  • Wrist & hand conditions – Scaphoid non-union, Carpal Tunnel Syndrome, base of thumb Arthritis
  • Knee Instability
  • Conditions of the Foot and Ankle – Hallux Valgus, arthritis
  • Previous arthroplasty hip and knee-Loosening, wear and infection

For other conditions, refer to:

  • Neck Pain, Back Pain & Sciatica – Refer to Austin or Alfred Hospital
  • Soft Tissue conditions of the Hand – Dupuytren’s contracture, tenosynovitis, ganglia – refer to Plastic Surgery Unit
  • Primary Bone or Soft Tissue TumoursRefer to St Vincent’s Health
  • Paediatrics – Clubfoot/Calcaneo Valgus Foot/Flat Feet / Intoeing/ Perthes /SUFE Refer to Royal Children’s Hospital
  • Simple fractures – follow the Simple Fracture Diversion Pathway – see map above. Please refer directly to the GPs listed if your patient fits the simple fracture pathway criteria below.
  • Minimally displaced fractures appropriate for simple fracture management:
    • Upper limb –
      • Clavicle (middle third, no skin tenting, <2cm overlap between fragments)
      • Surgical neck of humerus (impacted, displaced <10°)
      • Greater tuberosity of humerus (<5mm displacement)
      • Radial head and neck (angulation <10 °)
      • Distal radius (includes intra-articular fractures)
      • Paediatric distal radius/ulna (no clinical deformity, no growth plate involvement)
      • Scaphoid (undisplaced) and other carpals
    • Lower limb –
      • Weber A ankle fractures
      • Base of 5th metatarsal including Jones fractures
      • Other metatarsal fractures (<3 present, exclude Lisfranc injury)
      • Toe phalanx (all)
      • Lower limb stress fractures (all)

Any suspected fracture (not seen on x-ray) should also be diverted.

How to refer:

All referrals to Northern Health should be sent to:

Fax:    8405 8616

For detailed referral criteria and required supporting information please see HealthPathways Melbourne via the link below:

HealthPathways Melbourne – Orthopaedics

Referral must include:

  • Reason for referral – please include a working diagnosis and clinical history detailing the length of time the condition has been present, degree of pain and dysfunction or interference with occupation, past and current management of condition and response to this.
  • Medical History – current and relevant past
  • Current medications
  • Relevant Investigations and pathology – please include reports and histology
  • Patients must bring radiology films if not taken at Northern Health – a Radiology Report alone is not adequate for making decisions regarding surgery.

Director/Head of Unit      

Dr Juliette Gentle

Alternative service options

Sports / Soft Tissue Injury Clinic – via same referral process

Paediatrics – Clubfoot/Calcaneo Valgus Foot/Flat Feet / Intoeing/ Perthes/SUFE/ synovitis hip – Refer to Royal Children’s Hospital

Health Professional Enquiries :

Contact:     Orthopaedic Registrar via Northern Health switchboard – 8405 8000