The Effect of Corticosteroid Type on Failure Following Primary Trigger Finger Injection

The purpose of this study was to compare the failure rate of primary trigger finger corticosteroid injections (CSIs) using triamcinolone versus betamethasone.

This was a retrospective cohort study of all primary trigger finger CSIs given by a single fellowship-trained, hand surgeon over two 8-month periods. From June 2022 to January 2023, all trigger finger CSIs were performed with triamcinolone (1 mL, 40 mg/mL). From June 2023 to January 2024, all trigger finger CSIs were performed with betamethasone (1 mL, 6 mg/mL). Patient charts were reviewed at 1 year following the CSI to determine the failure rate of the CSI. Failure was defined as reintervention with either a repeat CSI or trigger finger surgery. For those patients who failed the primary CSI, the time to failure was recorded.

The two cohorts were similar in terms of finger laterality and finger distribution. In the triamcinolone cohort, 284 fingers in 238 patients received a primary trigger finger CSI. Within 1 year, 47 fingers (16.5%) had undergone either a repeat CSI (43 [15.1%]) or trigger release surgery (4 [1.4%]). In the betamethasone cohort, 255 fingers in 223 patients received a primary trigger finger CSI. Within 1 year, 89 fingers (34.9%) had undergone either a repeat CSI (73 [28.6%]) or trigger release surgery (16 [6.3%]). The percentage of patients undergoing repeat intervention was significantly greater in the betamethasone cohort (P < .05). Moreover, the betamethasone cohort had a significantly shorter mean time to failure as compared with the triamcinolone cohort (167 days vs 273 days, P < .05).

For primary trigger fingers, patients treated with a betamethasone CSI were significantly more likely to undergo a repeat CSI or trigger finger release surgery within 1 year of the CSI compared with patients treated with a triamcinolone CSI (P < .05). Betamethasone CSIs resulted in a significantly shorter time to failure than triamcinolone CSIs (P < .05).