Additional imaging not required. Further tests will be obtained by the specialist if necessary
Specify previous treatments (such as injections)
Within 12 months of referral
X-ray of the affected area
Within 12 months of referral
Arthritis of Hand
• Including thumb and fingers
Send referral to Calgary Zone FAST Team.
Please note a collaborative program exists between Orthopedic and Plastic Surgery in the Edmonton and Calgary Zones
Additional imaging not required. Further tests will be obtained by the specialist if necessary
Specify previous treatments (such as injections)
Within 12 months of referral
X-ray of the affected area
Within 12 months of referral
Arthritis of Wrist
Send referral to Calgary Zone FAST Team.
Please note a collaborative program exists between Orthopedic and Plastic Surgery in the Edmonton and Calgary Zones
Initial consultations are insured. Procedures may or may not be insured.
Asymmetrical Breasts
Send referral to Calgary Zone FAST Team.
Bony Orbital Deformity
For acute injuries < 4 weeks call RAAPID.
Send referral to Calgary Zone FAST Team.
For Soft tissue and Globe send to Ophthalmology, use Alberta Referral Directory to find out referral information.
If available:
• CT Facial Bones
Breast implant complication
Initial consultations are insured. Procedures may or may not be insured.
Breast Reconstruction
• Post Mastectomy
Send referral to Calgary Zone FAST Team.
If available:
• Include most recent oncology report.
For consideration of publicly insured coverage: | Significant impacts to quality of life (back pain, shoulder pain, paresthesia to arms) |>300grams of tissue to be removed per side
Initial consultations are insured. Procedures may or may not be insured
Large Breasts
• Breast Reduction
Send referral to Calgary Zone FAST Team.
• Provide BMI if available.
• List smoking status if available.
Include within the referral letter (Refer to clinical pathway for additional support): | Description of symptom onset and duration| Specify if atrophy or weakness present, as this impacts triage. | Functional status limitations | Treatments initiated and responses.
Carpal Tunnel SyndromeRefer to
Clinical Pathway: Carpal TunnelSend referral to Calgary Zone FAST Team.
Please note a collaborative program exists between Orthopedic and Plastic Surgery in the Edmonton and
Calgary Zones
• Electrodiagnostic studies should be ordered concurrently if atrophy/weakness present (i.e. severe carpal tunnel syndrome)
Description of wound (location, size, mechanism)
Duration of wound
List of treatments tried
Chronic Wound
• Non-healing
For patients with exposed vital structure call RAAPID
Send referral to Calgary Zone FAST Team.
Note: If the patient is already under the care or previously under care of a surgeon for this, please contact them
Congenital breast deformity
Initial consultations are insured. Procedures may or may not be insured.
Congenital Breast Deformity
Send referral to Calgary Zone FAST Team.
Consult for Cosmetic Referrals
Contact preferred surgeon directly (no FAST referral is required).
Craniofacial osseointegration consultation
Craniofacial Osseointegration Consultation (Implant)
Send referral to Calgary Zone FAST Team.
Approximate Date of injury
Specify location
Deformity After Injury
For acute injuries < 4 weeks call RAAPID.
Send referral to Calgary Zone FAST Team.
If available:
• CT Facial Bones
Deformity of wrist and/or hand
X-ray of the affected area
Deformity – Hand & Wrist
• Includes: Tendon related deformity (mallet finger, jersey finger, boutonniere’s)
Send referral to Calgary Zone FAST Team.
Please note a collaborative program exists between Orthopedic and Plastic Surgery in the Edmonton and Calgary Zones
Description of wound (location, size, mechanism)
Duration of wound
List of treatments tried
Diabetic Foot Ulcer• Wound
Refer to
CLINICAL PATHWAY: DIABETIC FOOT CARESend referral to Calgary Zone FAST Team.
If available:
• Any relevant diagnostic imaging already completed.
• Lower Limb Vascular non-invasive studies (segmental blood pressure measure and or arterial ultrasound) if available.
Dislocation of tendon, wrist or hand
Dislocation
HAND, FINGERS, AND WRIST
URGENT REFERRAL:
Call Surgeon on Call through RAAPID.
• If available, x-ray of affected
body part or joint
Dupuytren's disease of palm
Diagnostic ultrasound is not necessary.
Please specify degree of contracture | Tabletop Test Result | Operative intervention is primarily offered to patients who are unable to place their hand flat on the table or those with significant tenderness.
Dupuytren’s Contracture
• Fixed progressive flexion contracture of palmar fascia
Send referral to Calgary Zone FAST Team.
Please note a collaborative program exists between Orthopedic and Plastic Surgery in the Edmonton Zone.
Ear Deformity
For acute injuries < 4 weeks call RAAPID.
Send referral to Calgary Zone FAST Team.
Documentation of meeting Panniculectomy Clinical Indications for consideration for publicly insured surgery.
If patient does not meet panniculectomy clinical indications, patient can contact cosmetic plastic surgeon of their choice directly.
Excess Abdominal Skin
• For Panniculectomy
Send referral to Calgary Zone FAST Team.
Excess Eyelid Skin
Send referral to Calgary Zone FAST Team.
Eyelid Deformity
Send referral to Calgary Zone FAST Team.
Eyelid Ptosis
Send referral to Calgary Zone FAST Team.
Facial Asymmetry
Send referral to Calgary Zone FAST Team.
Include description of disease progression
Facial Nerve Paralysis
• Palsy Greater Than 3 Months
Send referral to Calgary Zone FAST Team.
Imaging results if available.
X-ray of affected body part or joint.
Fracture (> 4 weeks)
• Includes: Mal-union, non-union, fractures treated (surgically or non-surgically) outside of patient’s Zone but requiring treatment or follow up
> 4 weeks and patient is unattached to a surgeon, send referral to Calgary Zone FAST Team.
Note: If the patient is already under the care of an Orthopedic or Plastic surgeon for this injury, please contact them.
Fracture (< 4 weeks)
• Includes: Non-union, fractures treated (surgically or non-surgically) outside of patient’s Zone but requiring treatment or follow up
< 4 weeks – URGENT REFERRAL:
Call Surgeon on Call through RAAPID.
Note: If the patient is already under the care of an Orthopedic or Plastic surgeon for this injury, please contact them.
Gender affirming top surgery
Diagnosis of gender dysphoria by a specialist in transgender care
Initial consultations are insured. Procedures may or may not be insured.
Gynecomastia
Send referral to Calgary Zone FAST Team.
If available:
• List of medications
• Previous treatments (if any)
• Hormone levels as available
• Relevant bloodwork as available
If pain is related to another reason for referral, please order the appropriate investigations
Specify location of pain (thumb, metacarpal, phalangeal) and chronicity of pain
Within 12 months of referral
X-ray of the affected area
Within 12 months of referral
Hand pain
Send referral to Calgary Zone FAST Team.
Please note a collaborative program exists between Orthopedic and Plastic Surgery in the Edmonton and Calgary Zones
• Provide as much specificity as possible related to the pain in hand including duration of symptoms
Hidradenitis Suppurativa
Suggest dermatology assessment (if available in the zone) prior to referral to plastic surgery.
Send referral to Calgary Zone FAST Team.
Hyperhidrosis
Hyperhidrosis is not publicly insured.
Refer to plastic surgery or other providers who provide Botox injections for hyperhidrosis.
Infection of skin and/or subcutaneous tissue
Infection
URGENT REFERRAL:
Call Surgeon on Call through RAAPID.
Injury of blood vessels of upper extremity
Vascular Injury of the Upper Extremity
URGENT REFERRAL:
Call Surgeon on Call through RAAPID.
Include functional disability if present
Keloid Scar
Send referral to Calgary Zone FAST Team.
Ligament pathology of hand and/or wrist
X-ray of the affected area
Ligament Pathologies of Hand
• Includes: Chronic rupture of ulnar collateral ligament of thumb, Chronic tear of ligament of finger or thumb
Send referral to Calgary Zone FAST Team.
Please note a collaborative program exists between Orthopedic and Plastic Surgery in the Edmonton and
Calgary Zones
• Please consider printing this article for your patient to bring with them to complete the bilateral clenched fist view x-ray: “The “Clenched Pencil” View: A Modified Clenched Fist Scapholunate Stress View, JHS 2003.
• Additional imaging not required. Further tests will be obtained by the specialist if necessary.
Ligament pathology of wrist
Consider For Scapholunate ¿ Please also order bilateral x-ray clenched fist view.
Within 12 months of referral
X-ray of the affected area
Within 12 months of referral
Ligament Pathologies of Wrist
• Includes: Scapholunate, triangular fibrocartilage complex (TFCC) / distal radial ulnar joint (DRUJ) instability
Send referral to Calgary Zone FAST Team.
Please note a collaborative program exists between Orthopedic and Plastic Surgery in the Edmonton and Calgary Zones
• Please consider printing this article for your patient to bring with them to complete the bilateral clenched fist view x-ray: “The “Clenched Pencil” View: A Modified Clenched Fist Scapholunate Stress View, JHS 2003.
• Additional imaging not required. Further tests will be obtained by the specialist if necessary.
Include recurrent infections if present
Mass of wrist and/or hand
Ganglion: Ultrasound not required
Masses ¿ Ultrasound
Tenosynovitis - Ultrasound
Mass - Hand & Wrist
• Tumor or lump
• Includes: Ganglion cyst of tendon sheath, neuroma of hand, Schwannoma of nerve of upper limb, Ganglion of wrist
Send referral to Calgary Zone FAST Team.
Please note a collaborative program exists between Orthopedic and Plastic Surgery in the Edmonton and
Calgary Zones
• Dorsal Wrist Ganglion: Please consider up to 3 aspirations prior to referral.
Electrodiagnostic study results required as results impact triage decisions.
Please specify if wasting and weakness are present
Median Nerve Entrapment
• Other than carpal tunnel syndrome.
• Includes: Pronator Syndrome, Lacertus Syndrome
Send referral to Calgary Zone FAST Team.
Please note a collaborative program exists between Orthopedic and Plastic Surgery in the Edmonton and
Calgary Zones
Nasal Deformity
• Includes: Reconstruction, Septoplasty and Rhinoplasty
For acute injuries < 4 weeks call RAAPID.
Send referral to Calgary Zone FAST Team.
Nerve Injury
URGENT REFERRAL:
Call Surgeon on Call through RAAPID.
Pathologic Fracture
URGENT REFERRAL:
Call Surgeon on Call through RAAPID.
• If available, x-ray of affected body part or joint.
Plastic surgery consultation
Consult for Plastic Surgery
Send referral to Calgary Zone FAST Team.
Body part injured.
Include functional disability if present
Mechanism and date of injury
Post Burn Deformity
Send referral to Calgary Zone FAST Team.
Description of wound (location, size, mechanism)
Duration of wound
List of treatments tried
Pressure Ulcer
• Decubitus Ulcer
Send referral to Calgary Zone FAST Team.
Electrodiagnostic study results required as results impact triage decisions.
Please specify if wasting and weakness are present.
Radial Nerve Entrapment
• Includes: Radial Tunnel, PIN Compression, Wartenberg’s Syndrome
Send referral to Calgary Zone FAST Team.
Please note a collaborative program exists between Orthopedic and Plastic Surgery in the Edmonton and Calgary Zones
Rheumatoid hand deformity
Rheumatoid Hand
Refer to Rheumatology in order to medically optimize prior to surgical referral. Use Alberta Referral Directory to find out referral information.
For surgical referral: Send referral to Calgary Zone FAST Team.
Include functional disability if present
Scar
• Includes any abnormal, i.e. Hypertrophic
Send referral to Calgary Zone FAST Team.
Indicate Basal Cell, Squamous Cell, Melanoma or Other
Skin Cancer Biopsy Confirmed
Send referral to Calgary Zone FAST Team.
For rapid growing or changing skin cancers or greater than 1cm phone priority referral
Skull Deformity
• Includes: Cranioplasty
Send referral to Calgary Zone FAST Team.
If available:
• CT Head
Suspected benign neoplasm of skin
Functional limitations, additional symptoms (if any)
Suspected Benign Neoplasm of Skin Tumor
Send referral to Calgary Zone FAST Team.
May not be covered through public coverage
Suspected benign soft tissue mass
Functional limitations, additional symptoms (if any)
Suspected Benign Soft Tissue Mass
Send referral to Calgary Zone FAST Team.
May not be covered through public coverage
Suspected Skin Cancer
Send referral to Calgary Zone FAST Team.
Suspected soft tissue cancer
X-ray of affected body part or joint.
Suspected Tendon Rupture (> 4 weeks)
• Hand and wrist
• Includes laceration
> 4 weeks send referral to Calgary Zone FAST Team.
Suspected Tendon Rupture (< 4 weeks)
• Hand and wrist
• Includes laceration
< 4 weeks – URGENT REFERRAL:
Call Surgeon on Call through RAAPID.
Note: If the patient is already under the care of an Orthopedic or Plastic surgeon for this injury, contact them.
If available:
• Additional imaging not required. Further tests will be obtained by the specialist if necessary.
Tendon pathology of hand and/or wrist
If suspecting tear or instability of tendon: Ultrasound
If the patient has had steroid injections, please specify how many.
Tendon Pathology - Hand & Wrist
• Includes: Instability, tendonitis, tear, DeQuervain’s Tenosynovitis
Send referral to Calgary Zone FAST Team.
Please note a collaborative program exists between Orthopedic and Plastic Surgery in the Edmonton and
Calgary Zones
Diagnostic ultrasound is not necessary.
Include within the referral letter: | If the patient has previous intermittent locking/triggering and is unable to extend the finger at all even with passive extension. | Please comment on how many cortisone injections the patient has tried. | ***For a locked finger specify that it is unable to be manually unlocked.
Trigger Finger
• Intermittent triggering/locking/clicking with digital flexion/ extension.
Send referral to Calgary Zone FAST Team.
***For a digit that cannot be manually unlocked send through FAST and it will be prioritized.
If available:
• Please consider up to 2 cortisone injections approximately 8 weeks apart prior to referral.
Electrodiagnostic study results required as results impact triage decisions.
If loss of motion at the elbow, please provide x-ray of the affected elbow completed within 12 months
Please specify if wasting and weakness are present.
Ulnar Nerve Entrapment
• Includes: Cubital Tunnel, Guyon’s Syndrome
Send referral to Calgary Zone FAST Team.
Please note a collaborative program exists between Orthopedic and Plastic Surgery in the Edmonton and Calgary Zones
If pain is related to another reason for referral, please order the appropriate investigations
Specify location of pain (radial, central or ulnar, dorsal, volar) and chronicity of pain
Within 12 months of referral
X-ray of the affected area
Within 12 months of referral
Wrist pain
Send referral to Calgary Zone FAST Team.
Please note a collaborative program exists between Orthopedic and Plastic Surgery in the Edmonton and Calgary Zones
• Provide as much specificity as possible related to the pain in wrist including duration of symptoms