Open tendon laceration
URGENT hand surgery referral within 24 hours. Splint in safe position.
Symmetrical MCP/PIP swelling with morning stiffness >30 min
Suspected RA. URGENT rheumatology referral within 3 weeks. RF, anti-CCP, ESR, CRP.
Bite wound to hand (human or animal)
High infection risk. Antibiotics (co-amoxiclav), tetanus, X-ray. Hand surgery if deep.