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A collaboration between sports medicine physician, Dr. Jacquelyn Corkum, and the QEII Health Sciences Centre (QEII) plastic surgery team has led to the trial of a new hand assessment initiative that helps patients with trigger finger receive more timely initial assessments and management of their problem.
Trigger finger is a condition that causes the finger to get stuck in a bent position that then may straighten suddenly with a snap. This occurs when the tendons that control the finger become swollen or small lumps form. It can be quite painful and make it difficult to use the hand for normal functions. Treatments can include corticosteroid injections and splinting, and with more severe cases, or where symptoms persist, surgery to release the tendon.
“Hand function in central to daily life, so an issue like trigger finger can have a big impact,” says Dr. Corkum. “By assessing patients and providing non-surgical treatment sooner, the hand assessment initiative can help patients avoid long waits for surgical consults.”
Since starting the initiative in July of 2024, Dr. Corkum has seen over 200 patients for consults, who would have otherwise waited for a consult appointment with a plastic surgeon. So far, only 10 (less than 5 per cent) of these patients needed to be referred on to a surgeon for further follow-up.
With Dr. Corkum’s fellowship training in musculoskeletal medicine, she can also help provide the correct diagnosis if a patient does not have trigger finger but has similar symptoms.
“As surgeons, we have to triage the many patients who we are asked to see, which means patients with more serious conditions like skin cancers and traumatic injuries are seen first,” said Dr. Jason Williams, a Halifax-based plastic surgeon and head of the QEII Division of Plastic Surgery. “Unfortunately, patients with problems such as trigger finger tend to wait a long time to see us.
“The hand assessment initiative provides trigger finger patients with another option to connect them with the care they need and takes them out of the queue for surgical consults.”
Nova Scotia Health’s new electronic referral system helps provide visibility into the number of patients being referred with trigger finger, highlighting the need for the hand assessment initiative. As part of this system, the central intake that helps manage and coordinate referrals has been instrumental in identifying patients being referred who can first be directed to the hand assessment initiative.
Together, Dr. Corkum and the QEII plastic surgery team are transforming care for patients experiencing trigger finger and improving surgical access for those who need it.
"The hand assessment initiative for trigger finger is unique at this time,” says Dr. Williams, "and much credit has to go to the Perioperative Services team for supporting this initiative and making it a smooth process through the eReferral pathways. We look forward to exploring other applications of this model!”.
The central intake team is now working with Perioperative leaders to identify other types of less serious conditions that are commonly referred in the eReferral tool with the aim of exploring similar care models for these patients.
Learn more about how Nova Scotia Health efforts to improve and transform surgical access and care.
Photo of Dr. Jason Williams (left) and Dr. Jacquelyn Corkum (right).