Thanks to Plastics registrars Dr Daniel Reilly and Dr Felicity Connon for their presentation.

Points

1. remember that despite the rise of technology, solid basic descriptions are still the bedrock of a good referral. Use appropriate and precise terminology eg. radial / ulnar
2. The hand examination includes motor, sensory and tendon function components
3. Early washout in ED may prevent later complications – consider using 500-1000mL bags of NaCl 0.9% on pump set with a drawing up needle to facilitate large volumes of fluid under good pressure
4. Ensure your slabs are of appropriate weight so they do not fall apart before the first plastics clinic review
5. The Plastics team are keen to see all hand fractures, even ones that will be managed conservatively, so that patients can have access to a hand therapist
6. Nail bed injuries can be described by how proximal / distal to bone and nail bed, and if they are oblique