Orthopaedic trauma triage clinic / fracture clinic

SJH Emergency Medicine
NHS Lothian

You may refer patients directly to the orthopaedic trauma triage clinic using the Orthopaedic Trauma Triage clinic questionnaire on Trak. The x-rays and clinical notes will be reviewed by a consultant orthopaedic surgeon the next working day and the patient will be contacted within 5 working days with a plan for management of their injury. This may be to continue immobilisation and review in fracture clinic after one or two weeks and for some the plan will be to review the patient sooner. In a few cases the orthopaedic team will decide an operation is required. To ensure smooth referral process please ensure the following:

  • Patient’s phone number as stated on ED card is correct (check via the "MPI" function on TRAK)
  • You have entered a ‘diagnosis’ in the link above the TTC questionnaire
  • You have given the patient the appropriate ‘take home’ leaflet(s) (either general information leaflet
    or specific, and document this) - you can find these on the intranet currently

If you have any doubt over whether the patient requires an operation for their fracture then discuss with your ED senior or orthopaedics on call via RIE switchboard.

When doing a TTC referral please ensure TRAK gives you a pop-up box saying "TTC referral added". If not see the additional guidance.

Alternative clinics

At SJH ED only, some hand injuries can be referred to the plastic surgery hand trauma clinic. This is usually for fractures distal to, and including, metacarpal bones. See the hand injury guidance page for more advice.

TRAK failure to add TTC referral

There can be intermittent IT issues with TTC referrals. If you do not get the pop-up message on Trak to say 'TTC referral added' it may not have been sent. If this is the case, please email the TTC clinic to check (traumaenquiriesrie@nhslothian.scot.nhs.uk) if a referral has been received.

Also do bring this to the attention of the EPIC, and drop an email to the Clinical Director so that we can log if this is becoming a recurrent issue.

Please also ensure patients are discharged with the appropriate information leaflet, as per the ortho referral poster so they are aware of what follow up they should expect and the contact details for TTC.