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Steroid Injection and Open Trigger Finger Release Outcomes: A Retrospective Review of 999 Digits.

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Hand (New York, N.Y.)
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Recent steroid injections before open trigger finger release increase the risk of surgical site infections. Scheduling surgery more than 80 days after steroid injection can minimize infection risks for trigger finger treatment.

Keywords:
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Area of Science:

  • Orthopedic Surgery
  • Hand Surgery
  • Musculoskeletal Conditions

Background:

  • Open surgical release of the A1 pulley is the standard treatment for trigger finger (inflammatory stenosing tenosynovitis).
  • Concerns exist regarding steroid injections preceding surgery and their link to complications like wound infection.
  • No prior studies have specifically investigated the association between recent steroid injections and postoperative infections after trigger finger release.

Purpose of the Study:

  • To determine if recent steroid injection is associated with postoperative surgical infections following open trigger finger release.
  • To identify risk factors contributing to surgical site infections in trigger finger release patients.

Main Methods:

  • Retrospective chart review of 780 adult patients undergoing 999 open trigger finger releases between January 2014 and January 2016.
  • Data collected included steroid injection timing, number of injections, comorbidities, antibiotic use, and postoperative complications.
  • Analysis focused on the correlation between steroid injection timing and surgical site infections.

Main Results:

  • Steroid injection timing relative to surgery significantly correlated with postoperative surgical site infections.
  • Older age and shorter intervals (fewer days) between steroid injection and surgery were linked to higher infection rates.
  • Smoking, preoperative antibiotic use, and the use of lidocaine with epinephrine were also associated with increased infection risk.

Conclusions:

  • Steroid injections, smoking, increasing age, and shorter intervals between injection and surgery are identified risk factors for postoperative infections.
  • Recommendations include counseling patients on wound healing risks (especially smokers) and avoiding steroid injections close to surgery.
  • Scheduling surgery over 80 days post-injection and avoiding epinephrine in local anesthetics may reduce surgical site infection risks.