title: Comparative study on the effectiveness of corticosteroid injections between trigger fingers with and without proximal interphalangeal joint flexion contracture.
abstract: Trigger fingers with proximal interphalangeal joint flexion contracture are suggested to have a poorer response to corticosteroid injection than those without contracture, though this has not been proven scientifically. We compared the clinical response to corticosteroid injection between trigger fingers with and without proximal interphalangeal joint contracture, and investigated the influence of the injection on the A1 pulley and flexor digitorum tendons using ultrasonography. One month after injection, pain was significantly reduced in the no contracture group, and 56% of trigger fingers with proximal interphalangeal joint contracture resolved. Before injection, relative thickening of the A1 pulley and flexor digitorum tendons, and a partial hypoechoic lesion of the flexor digitorum superficialis tendon were observed in the contracture group. One month after injection, the thickening of the tendons and the A1 pulley was reduced, but the partial hypoechoic lesion was still observed in significant numbers. We have demonstrated that the presence of a proximal interphalangeal joint contracture was associated with a reduced clinical response to corticosteroid injection, and we suggest that the pathologic change in the flexor digitorum superficialis tendon, represented by the partial hypoechoic lesion, contributed to corticosteroid injection resistance.
  
  
  METHODS
  IV.
authors.affiliation: Department of Orthopaedic Surgery, Graduate School of Biomedical and Health Sciences, Hiroshima University, Minami-ku, Japan shinomi0123@yahoo.co.jp.
authors.forename: R
authors.initials: R
authors.lastname: Shinomiya
authors.affiliation: Department of Orthopaedic Surgery, Graduate School of Biomedical and Health Sciences, Hiroshima University, Minami-ku, Japan.
authors.forename: T
authors.initials: T
authors.lastname: Sunagawa
authors.affiliation: Department of Orthopaedic Surgery, Graduate School of Biomedical and Health Sciences, Hiroshima University, Minami-ku, Japan.
authors.forename: Y
authors.initials: Y
authors.lastname: Nakashima
authors.affiliation: Department of Orthopaedic Surgery, Graduate School of Biomedical and Health Sciences, Hiroshima University, Minami-ku, Japan.
authors.forename: Y
authors.initials: Y
authors.lastname: Kawanishi
authors.affiliation: Department of Orthopaedic Surgery, Graduate School of Biomedical and Health Sciences, Hiroshima University, Minami-ku, Japan.
authors.forename: T
authors.initials: T
authors.lastname: Masuda
authors.affiliation: Department of Orthopaedic Surgery, Graduate School of Biomedical and Health Sciences, Hiroshima University, Minami-ku, Japan.
authors.forename: M
authors.initials: M
authors.lastname: Ochi
mesh_terms: D000305:Adrenal Cortex Hormones / Q000008:administration & dosage*; D000368:Aged; D003286:Contracture / Q000503:physiopathology; D005260:Female; D005384:Finger Joint / Q000503:physiopathology*; D006801:Humans; D007267:Injections; D008297:Male; D008875:Middle Aged; D010147:Pain Measurement; D016896:Treatment Outcome; D052582:Trigger Finger Disorder / Q000188:drug therapy* / Q000503:physiopathology; D018084:Ultrasonography, Interventional
chemical_list: D000305:Adrenal Cortex Hormones
keywords: Trigger finger; comparative study; corticosteroid injection; proximal interphalangeal joint flexion contracture