Hand problems presenting to a district general hospital accident and emergency department

An audit was carried out of 1000 consecutive patients presenting with hand problems to a busy district general hospital (DGH), accident and emergency department (A&E). Hand problems accounted for 11% of all A&E presentations. Over 50% of cases were examined radiologically with 37% of these having positive findings. Most patients were male (66%) and manual workers (34%). Only 2.8% of patients required admission, and 50% were discharged with no follow-up. Less than 5% were referred by their general practitioner (GP) and these patients presented during office hours (08.00-18.00 h). The vast majority of the presenting patients could have been treated in a modern, well equipped GP surgery.