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Racial Disparities in Elective Surgical Management of Common Hand Pathologies
Mohammed M. Mumtaz, B.A.; Ellen S Satteson, MD
University of Florida, Gainesville, FL
Introduction Racial disparities in healthcare are well-documented, yet their prevalence in hand surgery is a growing area of research. The purpose of this study is to investigate racial differences in the rates of elective surgical interventions for hand pathologies frequently diagnosed in the outpatient setting.
Methods A retrospective analysis was conducted using ICD-10 diagnosis codes and CPT procedure codes through the IRB-approved University of Florida i2b2 Dataset, encompassing EPIC Electronic Health Record System data from patients between June 2011 and March 2024. The study population included individuals diagnosed with carpal tunnel syndrome, trigger finger, ganglion cyst of the wrist, De Quervain tenosynovitis, and Dupuytren contracture. We then measured the rates of surgical intervention among White and Black patients.
Results In all surgical interventions assessed, White patients consistently had surgery at higher rates than Black patients. Among patients diagnosed with carpal tunnel syndrome, 30.8% (3,339 out of 10,825) of White patients underwent surgery compared to 15.6% (510 out of 3,269) of Black patients. For trigger finger, 24.5% (1,459 out of 5,957) of White patients had surgery compared to 17.3% (249 out of 1,436) of Black patients. In cases of ganglion cysts of the wrist, 34.2% (616 out of 1,800) of White patients had surgery compared to 27.6% (161 out of 583) of Black patients. For De Quervain tenosynovitis, 14.5% (352 out of 2,424) of White patients had surgery compared to 9.8% (86 out of 881) of Black patients. The most striking difference was observed in Dupuytren contracture, with 15.6% (287 out of 1,845) of White patients undergoing surgery compared to 5.7% (3 out of 53) of Black patients.
Conclusion The analysis reveals substantial racial disparities in elective surgical management of common hand pathologies. Although existing literature documents disparities in surgical interventions for carpal tunnel syndrome and trigger finger, there is limited discussion concerning ganglion cysts, De Quervain tenosynovitis, and Dupuytren contracture. Contributing factors may include variations in access to healthcare, socioeconomic barriers, and possible biases in clinical decision-making. The consistency in racial disparities observed across several surgical interventions warrants further investigation to ensure equitable healthcare delivery.
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