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Trigger finger patients more likely to need surgery after two steroid injections
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CHICAGO — Researchers found outcomes were similar when they injected their patients with trigger finger one or two times with corticosteroids, according a presenter at the American Academy of Orthopaedic Surgeons Annual Meeting, here.
“There was no significant difference between these two groups,” William M. Sayde, MD, of Philadelphia, said during his presentation at the meeting. “We did find a higher surgical rate in the two-injection group. Right-handedness seems to be a predilection for patients who ended up requiring surgery,” he said.
The researchers randomized the 101 patients in the study into two groups. They gave 42 patients one injection of a 50% mixture of triamcinolone and local anesthetic and gave 59 patients the same concoction twice, with the second injection administered at 6 weeks. Sayde and colleagues followed up the patients at 6 weeks, 3 months, 6 months and 1 year after treatment.
According to details of the study, they considered the procedure a failure if patients needed another injection or subsequent surgery.
The researchers performed a Fisher’s exact test and found no significant difference in failure rates between one injection and two injection treatments, however patients in the two-injection group showed higher surgery rates and an earlier time to surgery than patients who received one injection.
“We found no significant benefit at giving patients the injection at the 4 to 6 week mark,” Sayde said. “But potentially giving them an injection at the 6 week to 6 month range might give them some benefit down the road,” he noted.
Reference:
Sayde W. Paper #148. Presented at: American Academy of Orthopaedic Surgeons Annual Meeting; March 19-23, 2013; Chicago.
Disclosure: Sayde has no relevant financial disclosures.