Intervention-Free Survival Analysis Following Corticosteroid Injection in First Dorsal Compartment Tendonitis

First dorsal compartment tendonitis is a common cause of radial wrist pain. Initial treatments include corticosteroid injections, bracing, and anti-inflammatory medications, with surgical release reserved for persistent symptoms. This study investigated the efficacy of injections and intervention-free survival time.

Patients at a single academic institution with first dorsal compartment tendonitis treated with at least one corticosteroid injection between 2014 and 2024 were included. Primary events were defined as a repeat injection or operative release. Time between injection and primary event was recorded and analyzed using the Kaplan-Meier product limit method.

Overall, 2,122 hands received a corticosteroid injection for first dorsal compartment tendonitis. With one injection, 66.5% of cases had no further intervention, which increased to 81.0% with two injections. Following an initial injection, 6.7% of cases progressed to surgery at a median of 111 days, and 26.8% had repeat injections. Intervention-free rates were 97% at 6 weeks, 87% at 3 months, and 75% at 6 months. After a second injection, 18.8% had a third injection at a median of 122 days, and 33.6% underwent surgical release. In the group with more than one injection, intervention-free rates were 97% at 6 weeks, 85% at 3 months, and 64% at 6 months.

A high proportion of patients with first dorsal compartment tendonitis appear to have symptom relief in response to corticosteroid injections. A second corticosteroid injection is less effective in reducing the need for operative release or repeat injection. Patients with first dorsal compartment tendonitis should be advised that corticosteroid injections generally provide relief and mitigate the need for repeat interventions.

Prognostic IV.