Socioeconomic and Demographic Influences on Trigger Finger Management: A Retrospective Cohort study

This retrospective cohort study looked at 2,639 adults with trigger finger treated at one academic hand practice from 2015-2020, asking whether age, race, insurance, and education predicted who ended up getting surgical release versus staying on conservative care. Only 16.2% ultimately had surgery, and after adjustment, older age, Asian/Pacific Islander race (adjusted OR 0.46 vs White patients), and having Medicare/Medicaid/uninsured status were all associated with lower odds of surgery, while patients with more than one insurance type had higher odds (adjusted OR 1.85). Insurance type was also linked to how long patients spent in conservative management before their last documented procedure, though not to how quickly they got to surgery once they had it.

AI summary · from the full text · reviewed by Pukhraj Gaheer, Medical Student, Queen's University before publishing

Why it mattersIt highlights that even a routine, algorithm-driven hand condition like trigger finger shows measurable racial and insurance-based gaps in who reaches definitive surgical treatment, a pattern residents should recognize when counseling patients about escalation of care.

Presenting this at rounds? Start here

• ?If a patient's insurance type seems to be prolonging their conservative management, how should that change your counseling about the timing of offering surgical release?
• ?Given the lower observed odds of surgery in Asian/Pacific Islander and older patients even after adjustment, how should surgeons check whether they are under-offering surgery to certain groups versus those patients genuinely preferring to avoid it?