Scientific articleA Prospective Randomized Controlled Trial of Injection of Dexamethasone Versus Triamcinolone for Idiopathic Trigger Finger
Section snippets
Materials and Methods
The study protocol was approved by our human research committee. Patients with idiopathic trigger finger that presented to the office of 1 of 3 hand surgeons between March 1, 2005, and November 30, 2005, were invited to participate in the study. Inclusion criteria included any adult patient (age 18 years or greater) with an isolated new diagnosis of 1 or more idiopathic trigger fingers of any Quinnell grade 2 or greater. According to the Quinnell system, trigger fingers are rated as follows: 0,
Baseline Patient Characteristics
There were no statistical differences in demographic and baseline study data between cohorts. (Table 1) Among the 40 patients in the dexamethasone cohort, the thumb was involved in 8, the index finger in 4, the long finger in 16, the ring finger in 7, and the small finger in 5. Among the 44 patients in the triamcinolone cohort, the thumb was involved in 13, the long finger in 14, the ring finger in 16, and the small finger in 1.
The average age of patients in the dexamethasone group was 63 years
Discussion
The injection of corticosteroids into the flexor sheath was initially advocated as a method of treatment for trigger finger in 1950.14, 15 The reported effectiveness has ranged between 25% and 73% (average, 49%) among 12 studies we identified.8, 14, 15, 16, 17, 18, 19, 20, 21, 22, 23, 24 In the largest retrospective study we are aware of (338 patients), the overall improvement or absence of triggering rate was 77%: 49% after a single injection, 23% after 2 injections, and 5% after 3 injections.8
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Establishing the Patient Acceptable Symptom State in a Nonshoulder Hand and Upper Extremity Population for the QuickDASH and PROMIS UE Computer Adaptive Tests
2024, Journal of Hand SurgeryCitation Excerpt :Christie et al36 estimated PASS thresholds for the Disabilities of the Arm, Shoulder, and Hand in patients who underwent shoulder surgery for rheumatological diseases using the 75th percentile and ROC-based methods, which yielded estimates of 42.9 and 43.0, respectively. This threshold represents a considerable degree of UE disability, and we acknowledge that patients may present before any intervention with a DASH score lower than the threshold established by Christie et al.36 Specifically, Ring et al37 noted an average preintervention DASH score of 23.2 in patients with trigger digits. This may be relevant to our threshold values as well given the broad range of pathology and procedures performed.
[Translated article] Out-of-sheath corticosteroid injections through the dorsal webspace for trigger finger and trigger thumb. A prospective cohort study
2022, Revista Espanola de Cirugia Ortopedica y TraumatologiaEfficacy of corticosteroid injection in rock climber's tenosynovitis
2019, Hand Surgery and RehabilitationCitation Excerpt :Alternatively, radial shockwave therapy has been shown to be somewhat effect in the treatment of chronic, non-inflammatory tendinosis to enhance neovascularization [28]. Various substances such as corticosteroids (triamcinolone, dexamethasone), hyaluronic acid, platelet rich plasma or NSAIDs are used in injection therapy [14–16,33,34]. Additionally, several taping methods were developed and analyzed biomechanically to deflect the course of the flexor tendons and thus decrease friction to the tendon sheath [17,35,36].
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2018, Archives of Physical Medicine and RehabilitationCitation Excerpt :We conclude that there is moderate evidence that TA injection is more effective than placebo for trigger finger in the very short term (1wk). Ring et al14 (low quality, n=84) compared an injection of triamcinolone with an injection of dexamethasone around the flexor tendon at the level of the A1 pulley. No significant differences were found on the Disability of the Arm, Shoulder and Hand Questionnaire (DASH-Q) at 3-month follow-up.
Support was received from AO Foundation, Wright Medical, Joint Active Systems, Smith and Nephew, Small Bone Innovations, and Biomet.