Safety and Efficacy of Low-Dose Triamcinolone Injection without Injection Frequency Limitation for Trigger Finger.

PURPOSE

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.

METHODS

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.

RESULTS

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.

CONCLUSIONS

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.