Comparison between corticosteroid injection and surgery in the treatment of trigger finger

Abstract

Abstract Background: Trigger finger is a common problem encountered in rheumatologic practice that causes a triggering or locking that may produce an uncomfortable sensation. There are various methods of treatment, ranging from conservative management to surgical release. Aim: To determine the effectiveness of corticosteroid injection and percutaneous release in terms of symptomatic relief, patient satisfaction and complications. Materials and Methods: In this prospective study, 50 patients who presented with trigger finger Grades 2 and 3 were randomized into two groups. One group received corticosteroid injection and, in the other group, percutaneous release was performed. These patients were then assessed weekly over a period of 6 weeks and their progress was noted. Results: Thirty cases (60%) were female and 20 cases (40%) were male. The age of the patients in this study was 40-65 years (mean: 48 years). Twenty-three cases (46%) were manual workers, 17 cases (34%) were semi-professionals and 10 cases (20%) were housewives. Most of the patients had involvement of the dominant hand (62%) and non-dominant hand involved in 38% of the cases. The most common presenting symptom was pain with triggering. In both groups, significant improvement in pain and triggering occurs in the first 2 weeks, but there was better improvement of pain and triggering in the corticosteroid group after 2 weeks. In terms of swelling of the digits, no difference was noted during the course of the treatment in the two groups. The corticosteroid group of patients had a complication rate of 6% and in the second group, the percutaneous group, had an 18% complication rate. There were a total of 12 patients who had recurrence (recurrence rate 24%): five (41.6%) cases in the first or corticosteroid group and seven (58.3%) cases in the surgery group. Conclusion: The group of patients treated with corticosteroid had a better relief of pain and triggering and had a lower complication rate. The recurrence was equal in both groups.