title: Outcomes of percutaneous trigger finger release with concurrent steroid injection.
abstract: Percutaneous release (PR) of the A1 pulley is a quick, safe, and minimally invasive procedure for treating trigger fingers. The purpose of this study is to identify if PR with additional steroid injections can shorten the recovery to reach unlimited range of motion. Between January 2013 and December 2013, we included 432 trigger fingers with actively correctable triggering or severer symptoms without previous surgical release or steroid injections from two hand clinic offices (A and B). The same experienced surgeon performed PR at the office. Patients from Clinic A received PR with steroid injections and those from Clinic B received PR without steroid injections. Patients returned for follow-up 1 week, 6 weeks, and 12 weeks after the procedure. Between the steroid group and the nonsteroid group, there is no significant difference in the mean time for patients to return to normal work and the rate of residual extensor lag. Middle fingers showed a 5.09-fold chance of having a residual extensor lag over that of the other fingers. High grade trigger fingers recovered more slowly than low grade ones. The success rate of a 12-week follow-up was 98.4%. There was no significant difference between the steroid group (97.5%) and the nonsteroid group (99.1%). PR can treat trigger fingers effectively, but additional steroid injection does not provide more benefit. Some fingers showed temporary extensor lag, especially in middle fingers and high grade trigger fingers, but 85% of those will eventually reach full recovery after self-rehabilitation without another surgical release.
authors.affiliation: Department of Orthopedic Surgery, Kaohsiung Medical University Hospital, Kaohsiung, Taiwan.
authors.forename: Wen-Chih
authors.initials: WC
authors.lastname: Liu
authors.affiliation: Department of Orthopedic Surgery, Kaohsiung Medical University Hospital, Kaohsiung, Taiwan.
authors.forename: Chun-Kuan
authors.initials: CK
authors.lastname: Lu
authors.affiliation: Department of Orthopedic Surgery, Kaohsiung Medical University Hospital, Kaohsiung, Taiwan.
authors.forename: Yu-Chuan
authors.initials: YC
authors.lastname: Lin
authors.affiliation: Department of Orthopedic Surgery, Kaohsiung Medical University Hospital, Kaohsiung, Taiwan; School of Medicine, College of Medicine, Kaohsiung Medical University, Kaohsiung, Taiwan.
authors.forename: Peng-Ju
authors.initials: PJ
authors.lastname: Huang
authors.affiliation: Department of Orthopedic Surgery, Kaohsiung Medical University Hospital, Kaohsiung, Taiwan; School of Medicine, College of Medicine, Kaohsiung Medical University, Kaohsiung, Taiwan.
authors.forename: Gau-Tyan
authors.initials: GT
authors.lastname: Lin
authors.affiliation: School of Medicine, College of Medicine, Kaohsiung Medical University, Kaohsiung, Taiwan; Division of Orthopedic Surgery, Kaohsiung Municipal Hsiao-Kang Hospital, Kaohsiung, Taiwan. Electronic address: microfu@gmail.com.
authors.forename: Yin-Chih
authors.initials: YC
authors.lastname: Fu
mesh_terms: D005260:Female; D006801:Humans; D007267:Injections; D016015:Logistic Models; D008297:Male; D008875:Middle Aged; D019637:Orthopedic Procedures; D013256:Steroids / Q000008:administration & dosage* / Q000627:therapeutic use*; D016896:Treatment Outcome; D052582:Trigger Finger Disorder / Q000188:drug therapy*
chemical_list: D013256:Steroids
keywords: Extensor lag; Percutaneous release; Steroid injection; Trigger finger