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A Prospective Study of the Response to Local Injection

Bruce Anderson, MD; Sam Kaye, MD

Arch Intern Med. 1991;151(1):153-156.

Abstract
We developed a protocol to maximize medical therapy for "trigger finger." Fifty-eight patients with 77 episodes of flexor tenosynovitis of the hand that was resistant to rest, therapy with nonsteroidal anti-inflammatory drugs, and/or splinting were treated with single or multiple injections of depo-methylprednisolone acetate or triamcinolone acetonide. Patients were prospectively followed up for an average of 4.6 years. Results showed that symptoms and signs resolved in 61% after a single injection. Recurrent episodes, after prolonged pain-free intervals, occurred in 27% and were effectively re-treated with injection. In 12% of cases, either injection failed or early recurrence required surgical release. Local adverse reactions to injection, including pain at the injection site, stiffness, ecchymosis, or atrophy of subcutaneous fat, were self-limited. No episodes of postinjection infection or tendon rupture occurred. The medical management of flexor tenosynovitis with local corticosteroid injection(s) is effective in nearly 90% of cases and is free from serious adverse reactions.

(Arch Intern Med. 1991;151:153-156)

Author Affiliations
From the Department of Medical Orthopedics, Northwest Permanente, Portland, Ore.

Footnotes
Accepted for publication July 10, 1990.

Reprint requests to Northwest Permanente, PC, 8007 SE 140th Dr, Portland, OR 97236 (Dr Anderson).

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