Efficacies of Different Managements in Patients With Trigger Finger

Gaziler Physical Medicine and Rehabilitation Education and Research Hospital

Status: Completed

Conditions: Trigger Finger

Treatments: Other: The peritendinous Betamethasone group; Procedure: The percutaneous A1 pulley release

Study type: Observational

Funder types: Other

Identifiers

NCT06382623

43

Details and patient eligibility

About

The aim of the study is to compare the effectiveness of peritendinous steroid injection under ultrasound guidance and percutaneous A1 pulley release procedures in terms of disease stage, pain, and severity of locking in patients with trigger finger.

Full description

This study was designed as a randomized, controlled, prospective study. Patients who had been experiencing trigger finger symptoms for at least one month and who presented to the Gaziler Physical Medicine and Rehabilitation Training and Research Hospital, affiliated with the Health Sciences University Faculty of Medicine

Patients were randomly divided into two groups: the peritendinous steroid group (n=15) and the percutaneous pulley release group (n=15). In the first group, under ultrasound guidance, a mixture of 1 ml corticosteroid (2 mg+5 mg/ml betamethasone) and 1 ml local anesthetic (20 ml 2% prilocaine) was injected peritendinously between the A1 pulley and the flexor tendon sheath. In the second group, a percutaneous A1 pulley release procedure was performed under ultrasound guidance using a 20 G needle, followed by peritendinous injection of the same mixture of corticosteroid and local anesthetic.

Patients were evaluated four times: before treatment, at 1 week, 1 month, and 3 months after treatment. Modified Quinnel classification, VAS (Visual Analog Scale), and severity of locking scales were used as outcome measures in the study.

Enrollment: 30 patients

Sex: All

Ages: 18+ years old

Volunteers: No Healthy Volunteers

Inclusion criteria

• Being over 18 years of age
• Having had trigger finger complaints for more than 1 month
• Not having received any injections for trigger finger diagnosis within the last 1 month
• Signing the informed consent form indicating willingness to participate in the study

Exclusion criteria

• Refusing to participate in the study
• Presence of partial or complete tendon rupture in the relevant tendon of the finger to be treated
• Presence of wounds and infection in the area where the procedure will be performed
• Pregnancy status
• History of allergy to the injected medications (local anesthetic, steroid)

Trial design

30 participants in 2 patient groups

The peritendinous steroid group

Description:

A 1 ml mixture of corticosteroid (2 mg + 5 mg/ml betamethasone) and 1 ml of local anesthetic agent (20 ml 2% prilocaine) was injected peritendinously between the A1 pulley and the flexor tendon sheath at the metacarpophalangeal joint level under ultrasound guidance.

Treatment:

Other: The peritendinous Betamethasone group

The percutaneous A1 pulley release group

Description:

In the A1 pulley release group, 1 ml of local anesthetic agent (20 ml 2% prilocaine) was injected into the pulley-associated subcutaneous tissue using a 27 G needle under ultrasound guidance. The metacarpophalangeal joint was brought into slight hyperextension. Subsequently, a 20 G 0.9x38mm needle, modified by bending approximately 40-45 degrees from the proximal 1/3 of the needle with the aid of a cap, was used. The needle was advanced in-plane from distal to proximal along the midline, with simultaneous movement towards the palmar surface, aiming to cut or loosen the pulley between the tendon and A1 pulley. The loosening procedure was repeated from the distal to proximal aspect of the pulley until the sensation of resistance at the needle tip disappeared.

Treatment:

Procedure: The percutaneous A1 pulley release