The Efficacy of Steroid Injection in the Treatment of Trigger Finger

Trigger finger or flexor tenosynovitis is one of the most common reasons for referral to hand surgery outpatient clinics.The lifetime risk of developing trigger finger is between 2% and 3%. 1) Patients frequently present with a painful triggering or clicking during active motion of an affected digit.This is due to the loss of normal smooth gliding of the tendon beneath the pulley system, most commonly at the level of the A1 pulley.This may be as a result of a nodule in the tendon or a diffuse swelling within the sheath as a result of a tenosynovitis.In 1953, Howard 2) described the technique of steroid injection into the flexor sheath as an effective treatment.Background: Trigger finger is one of the most common reasons for referral to a hand specialist clinic.The purpose of this study is to investigate the efficacy of steroid injections for treating trigger digits.Methods: Ninety digits were investigated with at least a year follow up.The study mainly focused on the efficacy of the injections, as well as co-morbidities, presence of a nodule, actual digit injected and the severity at presentation using Green's classification.Results: The study found that 66% of trigger digits were effectively treated using steroid injections.There was a difference between the efficacy of the injection in the different digits, with a statistical significance between the thumb and the fingers.The results also showed that there was no statistical relationship between the severity of the condition, the presence of a nodule or co-morbidities and the efficacy of the steroid injections.Conclusions: The study found that steroid injections are an effective first-line intervention for the treatment of trigger digit.It also found an increased efficacy for treating the thumb compared to other digits.Both the severity of the condition at presentation and the presence of a nodule had no significant impact on the efficacy of the injections.