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Corticosteroid injections effective for trigger finger in adults in general practice: a double-blinded randomized placebo controlled trial
  1. Cyriac Peters-Veluthamaningal (raju{at}dds.nl)
  1. University Medical Center Groningen, Netherlands
    1. Jan C Winters (j.c.winters{at}webnoord.nl)
    1. University Medical Center Groningen, Netherlands
      1. Klaas H Groenier (k.h.groenier{at}med.umcg.nl)
      1. University Medical Center Groningen, Netherlands
        1. Betty Meyboom-de Jong (b.meyboom-de.jong{at}med.umcg.nl)
        1. University Medical Center Groningen, Netherlands

          Abstract

          Objective: To study efficacy and safety of corticosteroid injections for trigger finger (flexor tenosynovitis) in adults in general practice.

          Methods: Adult patients presenting with trigger finger were recruited by 21 participating general practitioners. In this randomized placebo controlled double-blinded trial patients were injected locally with one or two injections of 1ml triamcinolonacetonide (TCA) or 0,9 % NaCl. Outcomes regarding immediate treatment response, severity of symptoms, functional disability, patient satisfaction and side-effects were measured one week after intervention and during 12 months thereafter.

          Results: 50 patients were included. Short term outcomes for the TCA- and NaCl-group were respectively: proportion of patients with satisfactory immediate treatment response 16/25 and 5/25 (p<0.0005), patients with reduction in the frequency of triggering 13/24 and 6/22 (p= 0.053) , mean difference in severity of pain 4.2 and 0.9 (p<0.0005), patients perceiving improvement 22/25 and 9/25 (p<0.0005) and difference in AIMS-2 score 4.02 and 0.06 (p=0.001) Long term effects could only be assessed by analyzing the cohort of participants who received TCA (as allocated treatment or escape treatment), due to a high proportion of non-responders in the NaCl-group.The short term beneficial effects were maintained during the follow-up phase of 12 months. Patients were satisfied with corticosteroid injection therapy and there were only a few minor side-effects.

          Conclusions: Local injection with triamcinolonacetonide is effective and safe for treating trigger fingers as compared to placebo injection. The effects of steroid injections last up to 12 months.

          • glucocorticoids
          • randomized controlled trial
          • stenosing tenosynovitis
          • therapy
          • trigger finger

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