title: Impact of Corticosteroid Injection Site on the Treatment Success Rate of Trigger Finger: A Prospective Study Comparing Ultrasound-Guided True Intra-Sheath and True Extra-Sheath Injections.
abstract: The aim of this study was to investigate whether differences in corticosteroid injection site influence the therapeutic effect on trigger finger and thickness of local structures such as the A1 pulley and flexor tendons. Previously untreated trigger fingers were randomly assigned to receive either a true intra-sheath (group I) or an extra-sheath (group E) injection under ultrasonographic guidance. Symptom remission and recurrence rates and recurrence timing did not significantly differ between the groups. Ultrasonography revealed mean (standard deviation) pre-injection A1 pulley thicknesses of 1.1 (0.3) and 1.1 (0.2) mm in groups I and E, respectively. One month after injection, these decreased to 0.7 (0.2) and 0.8 (0.2) mm, respectively (p < 0.05). Furthermore, mean (standard) pre-injection flexor digitorum tendon thickness was 4.1 (0.4) and 4.0 (0.5) mm in groups I and E, respectively, and, 1 mo after injection, decreased to 3.9 (0.3) and 3.8 (0.5) mm, respectively (p < 0.05). However, the difference at each time point between the two groups was not statistically significant. True intra-sheath injection offers no apparent advantage over extra-sheath injection for treating trigger fingers because both have the same effect on local structures.
authors.affiliation: Department of Orthopaedic Surgery, Graduate School of Biomedical and Health Sciences, Hiroshima University, Hiroshima, Japan. Electronic address: shinomi0123@yahoo.co.jp.
authors.forename: Rikuo
authors.initials: R
authors.lastname: Shinomiya
authors.affiliation: Department of Orthopaedic Surgery, Graduate School of Biomedical and Health Sciences, Hiroshima University, Hiroshima, Japan.
authors.forename: Toru
authors.initials: T
authors.lastname: Sunagawa
authors.affiliation: Department of Orthopaedic Surgery, Graduate School of Biomedical and Health Sciences, Hiroshima University, Hiroshima, Japan.
authors.forename: Yuko
authors.initials: Y
authors.lastname: Nakashima
authors.affiliation: Department of Orthopaedic Surgery, Graduate School of Biomedical and Health Sciences, Hiroshima University, Hiroshima, Japan.
authors.forename: Masaaki
authors.initials: M
authors.lastname: Yoshizuka
authors.affiliation: Department of Orthopaedic Surgery, Graduate School of Biomedical and Health Sciences, Hiroshima University, Hiroshima, Japan.
authors.forename: Nobuo
authors.initials: N
authors.lastname: Adachi
mesh_terms: D000368:Aged; D005260:Female; D005385:Fingers / Q000000981:diagnostic imaging; D005938:Glucocorticoids / Q000627:therapeutic use*; D006801:Humans; D015552:Injections, Intralesional; D008297:Male; D011446:Prospective Studies; D013710:Tendons / Q000000981:diagnostic imaging / Q000187:drug effects*; D016896:Treatment Outcome; D052582:Trigger Finger Disorder / Q000000981:diagnostic imaging / Q000188:drug therapy*; D018084:Ultrasonography, Interventional / Q000379:methods*
chemical_list: D005938:Glucocorticoids
keywords: Extra-sheath corticosteroid injection; Intra-sheath corticosteroid injection; Prospective study; Trigger finger; Ultrasonography