Risks of Perioperative Local Corticosteroid Treatment for Carpal Tunnel Syndrome and Trigger Finger: A Systematic Review and Meta-Analysis

Purpose To define procedure-specific, time-stratified surgical site infection (SSI) risk profiles following perioperative local corticosteroid injections (LCIs) in carpal tunnel release (CTR) and trigger finger release (TFR). Methods Following Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) 2020 guidelines, MEDLINE, Embase, and Cochrane Library were queried from inception to July 10, 2026, for cohort and case–control studies evaluating SSI following LCI within 6 months of CTR or TFR. Two reviewers independently screened studies, extracted data, and assessed quality using a 27-item modified Downs and Black checklist. DerSimonian–Laird random-effects models pooled odds ratios (ORs) for deep and superficial SSI across discrete preoperative intervals (≤30, 31–60, 61–90, and ≤90 days) and intraoperative administration. Bonferroni corrections (α = 0.05/m) were applied to independent comparisons. Results Twelve studies met inclusion criteria. For CTR, LCI ≤30 days showed a nominal association with higher deep SSI odds (OR 1.36, 95% CI 1.00–1.83; P = .048), not surviving Bonferroni correction (α = 0.0083); the ≤90-day composite was not significant (OR 1.07, 95% CI 0.79–1.46; P = .66). For TFR, LCI ≤90 days had significantly elevated deep SSI odds (OR 3.88, 95% CI 1.93–7.79; P < .001), driven by the ≤30-day window (OR 2.66, 95% CI 1.10–6.43; P = .03); individual windows did not survive family-wise correction. The only comparison surviving Bonferroni correction within a multi-comparison family was increased superficial SSI after TFR with preoperative distant large-/intermediate-joint LCI (OR 1.23, 95% CI 1.09–1.38; P < .001). Conclusions Pooled estimates suggest that the risk of postoperative infection may differ by injection timing, with a stronger however imprecise risk signal observed for TFR when LCI is administered within 30 days preoperatively. Surgical timing should be individualized and procedure-specific rather than based on rigid monthly intervals. Type of study/level of evidence Therapeutic III.