Treatment of trigger finger: randomized clinical trial comparing the methods of corticosteroid injection, percutaneous release and open surgery.
OBJECTIVE
The aim of this study is to evaluate the effectiveness of CS injection, percutaneous pulley release and conventional open surgery for treating trigger finger in terms of cure, relapse and complication rates.


METHODS
One hundred and thirty-seven patients with a total of 150 fingers were randomly assigned and allocated into one of the treatment groups, with treatments allocated into 150 opaque and sealed envelopes. We included patients >15 years of age with a trigger on any finger of the hand (Types II-IV) and used a minimum follow-up time of 6 months. The primary outcome measures were cures, relapses and failures.


RESULTS
Forty-nine patients were assigned to the conservative group to undergo CS injections, whereas 45 and 56 were assigned to undergo percutaneous release and outpatient open surgery, respectively. The trigger cure rate for patients in the injection method group was 57%, and wherever necessary, two injections were administered, which increased the cure rate to 86%. For the percutaneous and open release methods, remission of the trigger was achieved in all cases.


CONCLUSIONS
The percutaneous and open surgery methods displayed similar effectiveness and proved superior to the conservative CS method regarding the trigger cure and relapse rates. Trial registration. Current Controlled Trials, http://www.controlled-trials.com/, ISRCTN19255926.
Department of Orthopedics and Traumatology, Discipline of Hand and Upper Limb Surgery, UNIFESP - Federal University of São Paulo, São Paulo City, São Paulo, Brazil. edsonsasahara@ig.com.br
Edson S
ES
Sato
João B
JB
Gomes Dos Santos
João C
JC
Belloti
Walter M
WM
Albertoni
Flavio
F
Faloppa
D000293:Adolescent; D000328:Adult; D000368:Aged; D005260:Female; D005938:Glucocorticoids / Q000008:administration & dosage* / Q000009:adverse effects / Q000627:therapeutic use; D006801:Humans; D015552:Injections, Intralesional; D008297:Male; D008775:Methylprednisolone / Q000008:administration & dosage / Q000009:adverse effects / Q000031:analogs & derivatives / Q000627:therapeutic use; D000077555:Methylprednisolone Acetate; D008875:Middle Aged; D019060:Minimally Invasive Surgical Procedures / Q000009:adverse effects / Q000379:methods*; D019637:Orthopedic Procedures / Q000009:adverse effects / Q000379:methods*; D010146:Pain / Q000209:etiology; D016059:Range of Motion, Articular; D012008:Recurrence; D016896:Treatment Outcome; D052582:Trigger Finger Disorder / Q000188:drug therapy* / Q000601:surgery*; D055815:Young Adult
D005938:Glucocorticoids; D000077555:Methylprednisolone Acetate; D008775:Methylprednisolone