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Steroid injection versus NSAID injection for trigger finger: a comparative study of early outcomes.
- Source :
-
The Journal of hand surgery [J Hand Surg Am] 2012 Jul; Vol. 37 (7), pp. 1319-23. - Publication Year :
- 2012
-
Abstract
- Purpose: Stenosing tenosynovitis of the flexor tendon sheath of the digits of the hand results from a discrepancy between the diameter of the flexor tendon and its sheath at the A1 pulley. The treatment options for trigger digits include oral nonsteroidal anti-inflammatory drugs (NSAIDs) and local NSAID applications, splintage, steroid injection, and percutaneous and open release of the A1 pulley. Injectable NSAID is used intramuscularly and locally in other sites. The hypothesis is that an injectable NSAID is as effective as the traditionally used steroid injection in the treatment of trigger digit, based on Quinnell grading, and that the treatment works as well in patients with diabetes as in those without diabetes.<br />Methods: In this prospective, randomized, double-blinded controlled study for trigger digits, we injected diclofenac sodium locally in one group (NSAID group) and triamcinolone acetonide in another (corticosteroid group). A total of 100 patients (50 patients in each group) were followed up and assessed 3 weeks and 3 months after the injection.<br />Results: At the end of the follow-up, 35 patients (70%) in the corticosteroid group and 28 patients (53%) in the NSAID group had complete symptomatic resolution. There was no difference between the response of patients with and without diabetes. There was no significant difference found in Quinnell score between treatments at 3 months, although at 3 weeks, the patients who received steroid had significantly better Quinnell scores.<br />Conclusions: We concluded that, although steroids gave quicker relief, NSAID injections are equally effective at 3 months in the treatment of trigger digits. We were unable to detect a statistically significant difference in the response of patients with and without diabetes to either treatment.<br /> (Copyright © 2012 American Society for Surgery of the Hand. Published by Elsevier Inc. All rights reserved.)
- Subjects :
- Adult
Aged
Double-Blind Method
Female
Humans
Injections
Male
Middle Aged
Prospective Studies
Statistics, Nonparametric
Treatment Outcome
Trigger Finger Disorder complications
Anti-Inflammatory Agents, Non-Steroidal therapeutic use
Glucocorticoids therapeutic use
Triamcinolone Acetonide therapeutic use
Trigger Finger Disorder drug therapy
Subjects
Details
- Language :
- English
- ISSN :
- 1531-6564
- Volume :
- 37
- Issue :
- 7
- Database :
- MEDLINE
- Journal :
- The Journal of hand surgery
- Publication Type :
- Academic Journal
- Accession number :
- 22721455
- Full Text :
- https://doi.org/10.1016/j.jhsa.2012.03.040