Watanabe Jo, Matsuura Yusuke, Yamazaki Takahiro, Yamada Toshiyuki, Ohtori Seiji
Department of Orthopaedic Surgery, Matsudo City General Hospital, Matsudo, Chiba, Japan.
Department of Orthopaedic Surgery, Graduate School of Medicine, Chiba University, Chuo-ku, Chiba, Japan.
J Hand Surg Glob Online. 2025 Feb 5;7(2):225-231. doi: 10.1016/j.jhsg.2025.01.005. eCollection 2025 Mar.
Triamcinolone tendon sheath injection is a useful nonsurgical treatment for trigger finger; however, complications, such as tendon rupture, and infections caused by excessive administration, have been reported. Considering the complication risk, we inject 4 mg triamcinolone into the tendon sheath without limitation on the number of injections at intervals of at least 1 month. This study aimed to retrospectively examine the results of triamcinolone tendon sheath injections for trigger finger at multiple facilities.
The participants included patients with trigger finger who visited four facilities between April 2009 and October 2021, received at least one triamcinolone tendon sheath injection, and could be evaluated for effectiveness. Patients with a follow-up period of <3 months from the initial injection, and pediatric patients aged <16 years old were excluded. Quinnell's severity classification, number of injections per finger, interval of injections (when performed ≥2 times), complications, proportion of diabetes, hemoglobin A1c (HbA1c) levels, and proportion that required surgery were collected.
Overall, 356 cases and 715 fingers were included (men, 260 fingers; women, 455 fingers). The mean age of the participants was 64.9 years (17-92 years), and the mean number of affected fingers per person was 1.9 (1-7 fingers). The median follow-up period was 27 (3-134) months. According to Quinnell's severity classification, 234, 274, 126, and 50 fingers were classified as grade 1, 2, 3, and 4, respectively. The average number of injections per finger was 3.3. The mean interval between injections was 6.3 months. Complications, such as tendon rupture, or infection, were not observed. The rate of diabetes was 22.4%, and the median HbA1c value was 7.2%. In total, 9.8% of all patients required surgery.
No complications were observed for 4 mg triamcinolone injections when administered at intervals of at least 1 month.
TYPE OF STUDY/LEVEL OF EVIDENCE: Therapeutic Ⅳ.
曲安奈德腱鞘注射是治疗扳机指的一种有效的非手术治疗方法；然而，已有报道称存在诸如肌腱断裂等并发症以及因用药过量导致的感染。考虑到并发症风险，我们向腱鞘内注射4毫克曲安奈德，注射次数不限，间隔至少1个月。本研究旨在回顾性分析多家医疗机构中曲安奈德腱鞘注射治疗扳机指的结果。
研究对象包括2009年4月至2021年10月期间到四家医疗机构就诊、接受过至少一次曲安奈德腱鞘注射且可评估疗效的扳机指患者。排除初次注射后随访期<3个月的患者以及年龄<16岁的儿科患者。收集Quinnell严重程度分级、每根手指的注射次数、注射间隔（当注射≥2次时）、并发症、糖尿病比例、糖化血红蛋白（HbA1c）水平以及需要手术治疗的比例。
总共纳入356例患者的715根手指（男性260根手指；女性455根手指）。参与者的平均年龄为64.9岁（17 - 92岁），每人受影响手指的平均数量为1.9根（1 - 7根手指）。中位随访期为27（3 - 134）个月。根据Quinnell严重程度分级，分别有234、274、126和50根手指被分类为1级、2级、3级和4级。每根手指的平均注射次数为3.3次。注射的平均间隔为6.3个月。未观察到肌腱断裂或感染等并发症。糖尿病发生率为22.4%，HbA1c中位数为7.2%。所有患者中共有9.8%需要手术治疗。
当以至少1个月的间隔注射4毫克曲安奈德时，未观察到并发症。
研究类型/证据水平：治疗性Ⅳ级。
