The efficacy of steroid injection in the treatment of trigger finger

Benan M Dala-Ali, Amir Nakhdjevani, Mary A Lloyd, Frederik B Schreuder, Benan M Dala-Ali, Amir Nakhdjevani, Mary A Lloyd, Frederik B Schreuder

Abstract

Background: Trigger finger is one of the most common reasons for referral to a hand specialist clinic. The purpose of this study is to investigate the efficacy of steroid injections for treating trigger digits.

Methods: Ninety digits were investigated with at least a year follow up. The study mainly focused on the efficacy of the injections, as well as co-morbidities, presence of a nodule, actual digit injected and the severity at presentation using Green's classification.

Results: The study found that 66% of trigger digits were effectively treated using steroid injections. There was a difference between the efficacy of the injection in the different digits, with a statistical significance between the thumb and the fingers. The results also showed that there was no statistical relationship between the severity of the condition, the presence of a nodule or co-morbidities and the efficacy of the steroid injections.

Conclusions: The study found that steroid injections are an effective first-line intervention for the treatment of trigger digit. It also found an increased efficacy for treating the thumb compared to other digits. Both the severity of the condition at presentation and the presence of a nodule had no significant impact on the efficacy of the injections.

Keywords: Digit; Nodule; Steroid injections; Trigger finger.

Conflict of interest statement

No potential conflict of interest relevant to this article was reported.

Figures

Fig. 1
Fig. 1
A bar graph illustrating the efficacy of each steroid injection for treating trigger digits.
Fig. 2
Fig. 2
A picture and table showing the success of the steroid injections in treating different digits.
Fig. 3
Fig. 3
Bar graphs illustrating the difference in success of the steroid injection in treating nodular and diffuse patterns of trigger finger.
Fig. 4
Fig. 4
A graph illustrating the efficacy of steroid injection in treating osteoarthritis and diabetes mellitus.

References

    1. Strom L. Trigger finger in diabetes. J Med Soc N J. 1977;74(11):951–954.
    1. Howard LD, Jr, Pratt DR, Bunnell S. The use of compound F (hydrocortone) in operative and non-operative conditions of the hand. J Bone Joint Surg Am. 1953;35(4):994–1002.
    1. Green D, Hotchkiss R, Pederson W, Wolfe S. Green's operative hand surgery. 5th ed. London: Churchill Livingstone; 2005.
    1. Kerrigan CL, Stanwix MG. Using evidence to minimize the cost of trigger finger care. J Hand Surg Am. 2009;34(6):997–1005.
    1. Thorpe AP. Results of surgery for trigger finger. J Hand Surg Br. 1988;13(2):199–201.
    1. Turowski GA, Zdankiewicz PD, Thomson JG. The results of surgical treatment of trigger finger. J Hand Surg Am. 1997;22(1):145–149.
    1. Kazuki K, Egi T, Okada M, Takaoka K. Clinical outcome of extrasynovial steroid injection for trigger finger. Hand Surg. 2006;11(1-2):1–4.
    1. Anderson B, Kaye S. Treatment of flexor tenosynovitis of the hand ('trigger finger') with corticosteroids: a prospective study of the response to local injection. Arch Intern Med. 1991;151(1):153–156.
    1. Kolind-Sorensen V. Treatment of trigger fingers. Acta Orthop Scand. 1970;41(4):428–432.
    1. Newport ML, Lane LB, Stuchin SA. Treatment of trigger finger by steroid injection. J Hand Surg Am. 1990;15(5):748–750.
    1. Rhoades CE, Gelberman RH, Manjarris JF. Stenosing tenosynovitis of the fingers and thumb: results of a prospective trial of steroid injection and splinting. Clin Orthop Relat Res. 1984;(190):236–238.
    1. Marks MR, Gunther SF. Efficacy of cortisone injection in treatment of trigger fingers and thumbs. J Hand Surg Am. 1989;14(4):722–727.
    1. Freiberg A, Mulholland RS, Levine R. Nonoperative treatment of trigger fingers and thumbs. J Hand Surg Am. 1989;14(3):553–558.
    1. Weilby A. Trigger finger: incidence in children and adults and the possibility of a predisposition in certain age groups. Acta Orthop Scand. 1970;41(4):419–427.
    1. Fauno P, Andersen HJ, Simonsen O. A long-term follow-up of the effect of repeated corticosteroid injections for stenosing tenovaginitis. J Hand Surg Br. 1989;14(2):242–243.
    1. Clark DD, Ricker JH, MacCollum MS. The efficacy of local steroid injection in the treatment of stenosing tenovaginitis. Plast Reconstr Surg. 1973;51(2):179–180.
    1. Griggs SM, Weiss AP, Lane LB, Schwenker C, Akelman E, Sachar K. Treatment of trigger finger in patients with diabetes mellitus. J Hand Surg Am. 1995;20(5):787–789.
    1. Park J, Dumanian GA. Shower emboli and digital necrosis after a single corticosteroid injection for trigger thumb: case report. J Hand Surg Am. 2009;34(2):313–316.
    1. Sampson SP, Wisch D, Badalamente MA. Complications of conservative and surgical treatment of de Quervain's disease and trigger fingers. Hand Clin. 1994;10(1):73–82.
    1. Taras JS, Iiams GJ, Gibbons M, Culp RW. Flexor pollicis longus rupture in a trigger thumb: a case report. J Hand Surg Am. 1995;20(2):276–277.
    1. Fitzgerald BT, Hofmeister EP, Fan RA, Thompson MA. Delayed flexor digitorum superficialis and profundus ruptures in a trigger finger after a steroid injection: a case report. J Hand Surg Am. 2005;30(3):479–482.
    1. Chodoroff G, Honet JC. Cheiralgia paresthetica and linear atrophy as a complication of local steroid injection. Arch Phys Med Rehabil. 1985;66(9):637–639.

Source: PubMed

Sponsorer og samarbejdspartnere

Medicinske tilstande

Narkotikainterventioner

3
Abonner