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Injection versus surgery in the treatment of trigger finger
1Department of Orthopaedic Surgery, Northwestern University Medical School, Chicago, USA.
The Journal of Hand Surgery
|January 1, 1997
Summary
For trigger finger, surgery may be the best option after one steroid injection fails. While surgery costs more, it offers more permanent relief and patient satisfaction compared to repeat injections.
Area of Science:
- Orthopedics
- Hand Surgery
- Musculoskeletal Disorders
Background:
- Trigger finger (stenosing tenosynovitis) affects numerous patients, necessitating effective treatment strategies.
- Current management involves conservative options like steroid injections and surgical intervention.
Purpose of the Study:
- To compare the efficacy and cost-effectiveness of A1 pulley release surgery versus repeat local steroid injections for trigger finger.
- To evaluate patient satisfaction and clinical outcomes for both treatment modalities.
Main Methods:
- Retrospective review of 109 trigger fingers in 102 patients.
- Categorization into surgical release (34 digits) or local steroid injection (75 digits).
- Evaluation based on symptom resolution, treatment cost, and post-treatment patient questionnaires.
Main Results:
- Surgical release of the A1 pulley is a viable option for persistent trigger finger symptoms post-injection.
- Surgery incurs an additional cost but offers potentially permanent relief, justifying the expense.
- Patient-reported satisfaction data supports surgery as a reasonable choice after failed initial injection.
Conclusions:
- A1 pulley release surgery provides a durable solution for trigger finger refractory to initial steroid injection.
- The study aids in decision-making for optimal, individualized trigger finger treatment plans.
- Comparing surgical and non-surgical outcomes helps guide patient and physician choices.