Corticosteroid Injection in Diabetic Patients with Trigger Finger

Baumgarten, Keith M.; Gerlach, David; Boyer, Martin I.
December 2007
Journal of Bone & Joint Surgery, American Volume;Dec2007, Vol. 89-A Issue 12, p2604
Academic Journal
Background: it is generally accepted that the initial treatment for trigger finger is injection of corticosteroid into the flexor tendon sheath. In this study, the efficacy of corticosteroid injections for the treatment of trigger finger in patients with diabetes mellitus was evaluated in a prospective, randomized, controlled, double-blinded fashion and the efficacy in nondiabetic patients was evaluated in a prospective, unblinded fashion. Methods: Thirty diabetic patients (thirty-five digits) and twenty-nine nondiabetic patients (twenty-nine digits) were enrolled. The nondiabetic patients were given corticosteroid injections in an unblinded manner. The cohort with diabetes was randomized into a corticosteroid group (twenty digits) or a placebo group (fifteen digits). Both of these groups were double-blinded. Additional injections, surgical intervention, and recurrent symptoms of trigger finger were recorded. Treatment success was defined as complete or nearly complete resolution of trigger finger symptoms such that surgical intervention was not required. Results: After one or two injections, twenty-five of the twenty-nine digits in the nondiabetic group had a successful outcome compared with twelve of the nineteen in the diabetic corticosteroid group (p = 0.03) and eight of the fifteen in the diabetic placebo group (p = 0.006). With the numbers studied, no significant difference was found between the diabetic groups. Surgery was performed in three of the twenty-nine digits in the nondiabetic group compared with seven of the nineteen in the diabetic corticosteroid group and six of the fifteen in the diabetic placebo group. There was a significant difference in the prevalence of surgery between the nondiabetic group and both the diabetic corticosteroid group and the diabetic placebo group (p = 0.035 and p = 0.020, respectively). With the numbers studied, no difference was found between the diabetic groups with regard to the persistence of symptoms. Nephropathy and neuropathy were significantly associated with the need for surgery (p = 0.008 and p = 0.03, respectively). Conclusions: Corticosteroid injections were significantly more effective in the digits of nondiabetic patients than in those of diabetic patients. In patients with diabetes, corticosteroid injections did not decrease the surgery rate or improve symptom relief compared with the placebo. The use of corticosteroid injections for the treatment of trigger finger may be less effective in patients with systemic manifestations of diabetes mellitus.


Related Articles

  • Local corticosteroid injections improve symptoms of carpal tunnel syndrome.  // New Zealand Doctor;10/24/2007, p17 

    The article provides information on the effect of local corticosteroid injections on carpal tunnel syndrome (CTS), based on a study published in the 2007 issue of the Cochrane Database of Systematic Reviews. The condition is prevalent with 3.8% in the general population. The treatment offers...

  • High-pressure injection injury of the finger. Saraf, Sanjay // Indian Journal of Orthopaedics;Nov/Dec2012, Vol. 46 Issue 6, p725 

    Abstract: The high-pressure injection injuries are unusual injuries and the extent of tissue damage is often under estimated. They represent potentially disabling forms of trauma and have disastrous effects on tissues if not treated promptly. We present a case of high pressure injection injury...

  • Versatilidad del colgajo en hacha para reconstrucción de lesiones en punta de dedo. A., Fernández García; Soria Cogollos, T.; Moreno Villalba, R. A.; Fernández Pascual, C.; Alonso Rosa, S. // Cirugía Plástica Ibero-Latinoamericana;2008, Vol. 34 Issue 3, p235 

    The hatchet flap described by Emmet, has been recently applied by Tuncali et al. in fingertip amputations. This single triangular flap can be used in different types of injuries, as transverse and lateral oblique amputations. The aim of our study was to present the authors´ experience with...

  • Pulp thumb defect reconstruction using a twin neurovascular island flaps: a case report. Trevisan, Carlo; Mattavelli, Marta; Monteleone, Michele; Marinoni, Edoardo Carlo // Archives of Orthopaedic & Trauma Surgery;Feb2008, Vol. 128 Issue 2, p195 

    In this report, we present the functional and cosmetic results of a case with complete loss of the thumb pulp for which the Chen and Noordhoof techniques has been chosen for reconstruction. A 33-year-old man, artisan, had his right thumb caught in a machine during the work, resulting in a...

  • Reconstruction of Fingertip Amputation: Necrosis Is Expected. Sae Hwi Ki // Archives of Plastic Surgery;Jul2012, Vol. 39 Issue 4, p411 

    The article focuses on the possibility of necrosis following reconstruction of fingertip amputation caused by severe avulsion or crushing injury. It relates the factors affecting the success rate and complications in replantation and reconstruction of a fingertip amputation such as patient age,...

  • Percutaneous Release, Open Surgery, or Corticosteroid Injection, Which Is the Best Treatment Method for Trigger Digits? Wang, Jia; Zhao, Jia-Guo; Liang, Cong-Cong // Clinical Orthopaedics & Related Research;Jun2013, Vol. 471 Issue 6, p1879 

    Background: Percutaneous A1 pulley release surgery for trigger digit (finger or thumb) has gained popularity in recent decades. Although many studies have reported the failure rate and complications of percutaneous release for trigger digit, the best treatment for trigger digit remains unclear....

  • Trigger finger in adults. Ballard, Tiffany N. S.; Kozlow, Jeffrey H. // CMAJ: Canadian Medical Association Journal;1/1/2016, Vol. 188 Issue 1, p61 

    The article provides information about the condition known as trigger finger in adults. Topics discussed include the age when trigger finger often occurs, corticosteriod injection as the accepted first line treatment for the condition and the symptoms of trigger finger. Also discussed are the...

  • Use of digital nerve blocks to provide anaesthetic relief. Summers, Anthony // Emergency Nurse;Sep2011, Vol. 19 Issue 5, p25 

    This article discusses the various techniques that nurses can use to perform digital nerve blocks, which are some of the most common procedures undertaken by emergency practitioners treating patients with finger injuries. In covering the advantages and disadvantages of each technique, it focuses...

  • Replantation of a circumferentially degloved ring finger by venous arterializations. Xun Wang; Ping Zhang; Youqing Zhou // Indian Journal of Orthopaedics;Jul-Aug2013, Vol. 47 Issue 4, p422 

    Treatment of ring degloving injuries of the finger is one of the most demanding problems in hand surgery. Replantation has been advocated as the best solution if the vessels belonging to the degloved skin are not irreversibly destroyed. We present a case involving a ring finger with...


Read the Article


Sorry, but this item is not currently available from your library.

Try another library?
Sign out of this library

Other Topics