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Symptom Duration and Diabetic Control Influence Success of Steroid Injection in Trigger Finger.

Publication ,  Journal Article
Hollins, AW; Hein, R; Atia, A; Taskindoust, M; Darner, G; Shammas, R; Mithani, SK
Published in: Plast Reconstr Surg
August 1, 2022

BACKGROUND: Trigger finger is one of the most common hand abnormalities, with a prevalence of 2 percent of the general population. Conservative treatment with corticosteroid injections at the A1 pulley has been shown to be a cost-effective first-line treatment. However, additional patient factors have not fully been described regarding steroid injection efficacy. The authors hypothesize that patients presenting with longer chronicity of symptoms before treatment and elevated blood glucose would have reduced success rates of steroid injection therapy. METHODS: A retrospective chart review of 297 patients at a single institution was performed between 2013 and 2019. Patients were included if they presented with the diagnosis of trigger finger and were treated with initial corticosteroid injection at the A1 pulley. RESULTS: Steroid injection therapy alone was successful in 65 percent of patients. Patients received on average of 1.61 steroid injections. Patients who failed treatment received an average of 1.85 injections compared to 1.49 for those who had successful corticosteroid injection therapy ( p = 0.001). Presence of ipsilateral hand disease was associated with significant increase in failure of steroid injections (43.4 percent versus 30.8 percent; p = 0.032). Diabetic patients with hemoglobin A1c levels greater than 6.5 percent had a significantly higher rate of failing steroid injection therapy (71.9 percent versus 38.1 percent; p < 0.001). Patients who presented with greater than 2.5 months of symptoms had a higher failure rate of corticosteroid therapy (40.4 percent versus 29.5 percent; p = 0.048). CONCLUSION: Patients with a coexisting diagnosis of diabetes and a hemoglobin A1c level greater than 6.5 percent, ipsilateral concomitant hand disease, or presence of symptoms for greater than 2.5 months should be counseled regarding higher risk of failure of local corticosteroid injection. CLINICAL QUESTION/LEVEL OF EVIDENCE: Risk, III.

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Published In

Plast Reconstr Surg

DOI

EISSN

1529-4242

Publication Date

August 1, 2022

Volume

150

Issue

2

Start / End Page

357e / 363e

Location

United States

Related Subject Headings

  • Trigger Finger Disorder
  • Treatment Outcome
  • Surgery
  • Steroids
  • Retrospective Studies
  • Humans
  • Glycated Hemoglobin
  • Diabetes Mellitus
  • Adrenal Cortex Hormones
  • 3203 Dentistry
 

Citation

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Hollins, A. W., Hein, R., Atia, A., Taskindoust, M., Darner, G., Shammas, R., & Mithani, S. K. (2022). Symptom Duration and Diabetic Control Influence Success of Steroid Injection in Trigger Finger. Plast Reconstr Surg, 150(2), 357e-363e. https://doi.org/10.1097/PRS.0000000000009320
Hollins, Andrew W., Rachel Hein, Andrew Atia, Mahsa Taskindoust, Grant Darner, Ronnie Shammas, and Suhail K. Mithani. “Symptom Duration and Diabetic Control Influence Success of Steroid Injection in Trigger Finger.Plast Reconstr Surg 150, no. 2 (August 1, 2022): 357e-363e. https://doi.org/10.1097/PRS.0000000000009320.
Hollins AW, Hein R, Atia A, Taskindoust M, Darner G, Shammas R, et al. Symptom Duration and Diabetic Control Influence Success of Steroid Injection in Trigger Finger. Plast Reconstr Surg. 2022 Aug 1;150(2):357e-363e.
Hollins, Andrew W., et al. “Symptom Duration and Diabetic Control Influence Success of Steroid Injection in Trigger Finger.Plast Reconstr Surg, vol. 150, no. 2, Aug. 2022, pp. 357e-363e. Pubmed, doi:10.1097/PRS.0000000000009320.
Hollins AW, Hein R, Atia A, Taskindoust M, Darner G, Shammas R, Mithani SK. Symptom Duration and Diabetic Control Influence Success of Steroid Injection in Trigger Finger. Plast Reconstr Surg. 2022 Aug 1;150(2):357e-363e.

Published In

Plast Reconstr Surg

DOI

EISSN

1529-4242

Publication Date

August 1, 2022

Volume

150

Issue

2

Start / End Page

357e / 363e

Location

United States

Related Subject Headings

  • Trigger Finger Disorder
  • Treatment Outcome
  • Surgery
  • Steroids
  • Retrospective Studies
  • Humans
  • Glycated Hemoglobin
  • Diabetes Mellitus
  • Adrenal Cortex Hormones
  • 3203 Dentistry