Effects of simultaneous steroid injection after percutaneous trigger finger release: a randomized controlled trial

Abstract

The purpose of this study was to test the hypothesis that an improved outcome can be achieved by employing simultaneous steroid injection after percutaneous A1 pulley release. One hundred and twelve digits were randomized to either percutaneous A1 pulley release alone or release of the A1 pulley with a steroid injection. The visual analogue scale score for pain, modified patient global impression of improvement and modified Quinnell grade were assessed at 3 weeks and 3 months after surgery. At 3 weeks, subjective improvement in the group with simultaneous steroid injection was significantly superior. At 3 months, pain score in the patients without a steroid injection was significantly better. No significant differences were found in the modified Quinnell grade. We conclude from this study that the simultaneous steroid injection at the time of surgical release decreases pain and improves subjective outcomes during the early postoperative period after percutaneous trigger finger release. Level of evidence: I

Sonographically controlled percutaneous A1 pulley release using a new guide instrument – a case series of 106 procedures in 64 patients

“…Contrary to open pulley release, synovectomy is not possible in percutaneous surgery and may account for this sonographic nding present up to several months postoperatively. Several authors describe the use of concurrent cortisone, which may address this issue 26,27,32 . However, the vast majority of patients in our small case series were asymptomatic despite the presence of this sonographic nding.…”

“…Interestingly, it has been shown that with combined corticosteroid injection during percutaneous release, postoperative swelling has been reduced without more wound healing complications. 26,27 Other complications were only visible in cases that needed conversion to an open procedure and were caused by incorrect placement of the guide instrument or hook knife. After design revision, conversion to an open procedure has been necessary twice as a precautionary measure and we have not seen injuries in these two cases.…”

“…Cadaveric studies 3,[21][22][23][24][25] have examined the feasibility of different techniques. In combination with injection of corticosteroids during percutaneous release, swelling after the procedure seems to be advantageous without more wound healing complications 26,27 .…”

A cadaveric assessment of percutaneous trigger finger release with 15° stab knife: its effectiveness and complications

“…The only operation time in the guidance of the ultrasound group was longer [ 33 ]. Compared to these studies, Jegal et al (2018) showed that topical injection of corticosteroids after the percutaneous release can improve treatment outcomes and reduce patient pain in the short period after surgery [ 34 ].…”

Complications of Percutaneous Release of the Trigger Finger

“…Treatment of trigger finger usually is conservative if it is uncomplicated and if it has a short history of symptoms. It includes steroid injections and splinting [2,3,4]. Percutaneous trigger finger release is simple and effective with success rates of 84% to 100% at the mid-term follow-up [4,5,6].…”