Comparing the Corticosteroid Injection and A1 Pulley Percutaneous Release in Treatment of Trigger Finger: A Clinical Trial

Abstract

Background: Primary treatment of trigger digits is conservative including stretching, night splinting and combination of heat and ice. When these methods fail, invasive methods such as corticosteroid injection, percutaneous release and open surgery are used. The purpose of this study is to compare the efficacy of two outpatient methods of percutaneous trigger finger release (PTFR) and corticosteroid injection (CI). Methods: This study is a randomized clinical trial that was performed with 6-month follow up. A total of 83 patients with trigger finger treated either with corticosteroid injection (n:40) or percutaneous release of the A1 pulley (n:43) were enrolled in this study. Demographic data were recorded before intervention. Pain score (VAS criterion), disease stage (Quinnell criteria), patient satisfaction and complications such as paresthesia, scarring, and stiffness (decrease in the range of motion) were recorded after the intervention. We used SPSS program (statistical package for the social science SPSS version 16) to perform the analysis. Results: There were 18 male (21.7%) and 65 female (78.3%) patients, whose mean age was 52.54 ± 11.45 (28–85) years. There was a significant difference between the degree of pain at the time of the third, sixth weeks and sixth months in two groups. The degree of pain was lower in the CI group in the third and sixth weeks but it was lower in the PTFR group in the sixth month. Satisfaction of the patients in the sixth month was significantly higher in the PTFR group. The incidence of stiffness was also significantly lower in the PTFR group in the sixth month. Conclusions: Patients in PTFR group had greater recovery and satisfaction level and lower recurrence rate and pain. Therefore PTFR may be used as a substitute for CI in the treatment of trigger finger from the beginning especially in patients who do not want to have open surgery.