Stenosing flexor tenosynovitis.
A review of 253 consecutive digits with stenosing flexor tenosynovitis was done to clarify the respective role of steroid injection and surgical release in the management of stenosing flexor tenosynovitis. Treatment selection was based on the patient's age and severity of presenting complaints. In patients aged 10 years or more, analysis showed no statistically significant difference between results with steroid injection and surgical release. Surgical treatment was associated with higher cost and more complications. Based on this review, we recommend up to three injections of 20 mg of triamcinolone into the digital flexor sheath as the initial management of nonlocking, stenosing flexor tenosynovitis in adults. Initial management by surgical release is reserved for children and patients with digits locked in flexion.
Division of Plastic and Reconstructive Surgery, Washington University School of Medicine, St. Louis, Mo.
B A
BA
Kraemer
V L
VL
Young
C
C
Arfken
D000293:Adolescent; D000328:Adult; D000367:Age Factors; D000368:Aged; D000369:Aged, 80 and over; D002648:Child; D002675:Child, Preschool; D003131:Combined Modality Therapy; D003161:Compartment Syndromes / Q000188:drug therapy / Q000601:surgery / Q000628:therapy*; D005069:Evaluation Studies as Topic; D005260:Female; D005384:Finger Joint; D005500:Follow-Up Studies; D006801:Humans; D007223:Infant; D008297:Male; D008875:Middle Aged; D012008:Recurrence; D012189:Retrospective Studies; D013518:Surgery, Plastic / Q000379:methods; D013717:Tenosynovitis / Q000188:drug therapy / Q000601:surgery / Q000628:therapy*; D014221:Triamcinolone / Q000627:therapeutic use
D014221:Triamcinolone