Trigger fingers and thumb: when to splint, inject, or operate.
Fifty trigger fingers were treated by splinting of the metacarpophalangeal joint at 10 to 15 degrees of flexion for an average of 6 weeks (range, 3 to 9 weeks). Another 50 trigger fingers were injected with 0.5 ml of betamethasone sodium phosphate and acetate suspension (Celestone) and 0.5 ml of lidocaine. All patients were followed up for a minimum of 1 year (range, 1 to 4 years). Treatment was successful in 33 (66%) of the splinted digits and 42 (84%) of the injected digits. Fifty percent of the 10 splinted thumbs and 70% of the 40 splinted fingers had a successful outcome. Of the 17 unsuccessfully treated digits in the splinted group, 15 were later cured with injections and 2 required surgery. All of the 7 unsuccessfully treated digits in the injected group were cured with surgery. Patients with marked triggering, symptoms of more than 6 months' duration, and multiple involved digits had a higher rate of failure in both groups. Splinting offers an alternative for patients who have a strong objection to cortisone injection.
Patel
M R
MR
Division of Orthopedic Surgery, Maimonides Medical Center, Brooklyn, N.Y.
Bassini
L
L
D003348:Cortisone / Q000008:administration & dosage / Q000627:therapeutic use*; D005384:Finger Joint / Q000002:abnormalities; D005500:Follow-Up Studies; D006801:Humans; D007267:Injections; D016916:Joint Deformities, Acquired / Q000628:therapy*; D013165:Splints; D013933:Thumb / Q000002:abnormalities; D016896:Treatment Outcome
D003348:Cortisone