Steroid versus placebo injection for trigger finger*

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The ability of a single injection of steroid and lidocaine to bring about cure of primary trigger finger was determined and compared with a control placebo injection of only lidocaine. Twenty-four patients were randomized to the therapeutic or control group and were followed prospectively. One physician administered the injection, another the clinical examination after injection, and a third evaluated the results blindly. Patients were not told to which group they were assigned. Nine of the 14 patients in the steroid group versus two of the ten patients in the placebo group were cured of trigger finger at final follow-up examination. After injection, seven patients had immediate but temporary relief of triggering because of flexor sheath distention. One injection cured 16 of patients with primary trigger finger with no side effect and is the recommended nonsurgical treatment.

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Cited by (124)

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    2022, Revista Espanola de Cirugia Ortopedica y Traumatologia
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    The goal of treatment is to restore smooth, painless gliding of the tendons and full range of motion in the affected finger. Trigger fingers can be effectively and efficiently treated by steroid injections,3–8 but pain experienced by the patient is an ever-present side effect. Few studies have assessed patient-perceived pain during trigger finger injections, but the score seems to vary depending on the injection technique.9–13

  • A Cost-Effectiveness Analysis of Corticosteroid Injections and Open Surgical Release for Trigger Finger

    2020, Journal of Hand Surgery
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    In other words, if the cost of performing open surgical release in the clinic setting is below a certain threshold, immediate surgery would be cost-effective, assuming such procedures incur complication rates similar to those performed in the operating room. Although most previous studies reported steroid injection success rates above 47% for the first injection and over 23% for the second injection,21–27 the probability of success for the third injection is more controversial; reports range from 0% to 75%.5,11,25,27–29 Interestingly, more recent studies with larger cohort sizes tend to report higher rates of success for the third injection.5,29

  • Effectiveness of Conservative, Surgical, and Postsurgical Interventions for Trigger Finger, Dupuytren Disease, and De Quervain Disease: A Systematic Review

    2018, Archives of Physical Medicine and Rehabilitation
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    Two low-quality RCTs (n=63) that both compared the effects of local corticosteroid injection plus lidocaine injection with lidocaine injection alone were included.21,22 Murphy et al21 studied betamethasone and lidocaine for the treatment group and lidocaine for the control group in the short and midterm; Lambert et al22 used methylprednisolone and lidocaine for the treatment group and lidocaine for the control group in the short term. The meta-analysis on treatment success showed significant differences in favor of local corticosteroid injections (relative risk, 3.15; 95% confidence interval [CI], 1.34–7.40) at 4-week follow-up.

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*

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1

From the Henry Ford Hospital, Department of Orthopaedic Surgery, Detroit, MI.

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