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BACKGROUND Trigger finger is a common disorder of the hand that can cause disabling symptoms. Treatment options range from conservative management with observation and splinting, to surgical release, but there is currently not a consensus on a treatment algorithm. AIM To determine patient preference for the treatment of trigger finger using an online survey. METHODS An online crowdsourcing platform, Amazon Mechanical Turk, was used to recruit participants for this study. Participants were led through a scenario in which they were diagnosed with trigger finger. They were then asked to rank their preference of treatment options from the following: Observation, splinting, corticosteroid injection, surgery. The results of the surveys were then analyzed using R software. RESULTS Of 323 participants completed the survey. 7 participants were excluded because they failed to correctly answer the attention question, leaving 316 participants whose results were included. As a first choice for treatment 117 (37%) of the included participants chose observation, 86 (27%) chose splinting, 61 (19%) chose corticosteroid injection, and 52 (16%) chose surgery. The mean rank for observation was 2.26, for splinting was 2.30, for corticosteroid injection was 2.53, and for surgery was 2.91. The ranking of each treatment option was statistically different ( P value < 0.05) from the others except for observation and splinting. CONCLUSION The practice of shared decision making with patients is imperative to providing the best care possible. The results from this study, especially the preference for less invasive treatment, may help providers better frame discussion around treatment options of trigger fingers. This in turn, may increase patient satisfaction in the treatment of trigger finger.

Context: It is unknown how specific coping strategies are associated with the short-term outcomes among athletes following knee surgery. Objective: 1) To determine whether specific coping strategies are associated with satisfaction, return to sport, self-reported knee function, or kinesiophobia following sports-related knee surgery. 2) To determine whether these associations vary by age, sex, or surgical procedure. Study design: Case series. Methods: Athletes (n=184 total; n=104 men, n=80 women; n=38 age &lt;20 years, n=35 age 20–25, n=36 age 26–31, n=36 age 32–40, n=39 age &gt;40) who underwent outpatient knee surgery were enrolled from a single center. Utilization of specific coping strategies (self-distraction, use of emotional or instrumental support, venting, positive reframing, and acceptance) was assessed pre-operatively with the Brief-COPE inventory. Relationship between coping strategies and post-operative satisfaction, return to sport, International Knee Documentation Committee-subjective (IKDC-S) and Tampa Scale for Kinesiophobia scores at median 10.7 months follow-up were determined with consideration for age, sex, and surgical procedure. Results: Return to prior level of sport was 72%, and satisfaction was 86%. Most coping strategies had age-specific utilization rates; positive reframing was utilized least frequently in ages &lt;20 years. Satisfaction increased with greater positive reframing among ages &lt;20 years and decreased with greater self-distraction among men. Return to sport was higher with greater positive reframing in ages &lt;32 years. No coping strategies predicted IKDC-S scores. Greater positive reframing correlated with lower kinesiophobia in ages &lt;20 years. Greater instrumental support correlated with lower kinesiophobia in ages &gt;40 years. No other coping strategies were associated with outcomes. Surgical procedure was not related to association between coping strategies and outcomes. Conclusion: Coping strategies have age-specific associations with outcomes after knee surgery in athletes. Positive reframing is infrequently utilized in younger athletes. Greater use of positive reframing in this group may improve satisfaction, return to sport, and lower fear of re-injury.

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