Comparison between triamcinolone injection and hydrocortisone injection in treatment of trigger finger: a prospective single-blinded randomized controlled study

Trigger finger is a term for stenosing tenovaginitis affecting the excursion of the long flexor of the hand at the area of zone II of the digit. Steroid injection is one of the treatment option. Triamcinolone is the steroid mainly used for trigger finger treatment. Hydrocortisone is used only in pa...

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Main Author:	Mohd Ramli, Radzeli
Format:	Thesis
Language:	English
Published:	2011
Subjects:	RD701-811 Orthopedic surgery
Online Access:	http://eprints.usm.my/38096/1/Pages_from_Radzeli_Mohd_Ramli-RD701-811.pdf
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spelling	my-usm-ep.380962019-04-12T05:26:44Z Comparison between triamcinolone injection and hydrocortisone injection in treatment of trigger finger: a prospective single-blinded randomized controlled study 2011 Mohd Ramli, Radzeli RD701-811 Orthopedic surgery Trigger finger is a term for stenosing tenovaginitis affecting the excursion of the long flexor of the hand at the area of zone II of the digit. Steroid injection is one of the treatment option. Triamcinolone is the steroid mainly used for trigger finger treatment. Hydrocortisone is used only in paeditric trigger finger. Therefore result and outcome of hydrocortisone in treatment of adult trigger finger still not establish. PURPOSE: This study was designed to test the null hypothesis that there is no difference in resolution of trigger finger in term of pain, tenderness and triggering/locking in 3 months after injection with triamcinolone, a depot form of potent steroid or hydrocortisone, a highly soluble form but less potent steroid. METHODS: Seventy patients were enrolled in a prospective randomized controlled study comparing triamcinolone and hydrocortisone injection for idiopathic trigger finger. They were randomized into two groups; triamcinolone group and hydrocortisone group. All patients required to answer DASH questionnaire, give VAS score and evaluated for triggering/locking and tenderness at A1 pulley before injection, immediately after injection and 3 months after injection. Fifty-nine patients completed the 3 months follow-up (28 triamcinolone arm, 31 dexamethasone arm). Outcome measures included the Disabilities of the Arm, Shoulder, and Hand (DASH) questionnaire, presence/absence of triggering/locking finger, presence/absence of A1 pulley tenderness and pains severity base on visual analog scale. A Chi-square test and student t-test were used to compare both groups. RESULTS: Immediately after injection, absence of triggering was documented in 24 of 34 patients (70.6%) in the triamcinolone group and in 28 of 36 patients (77.8%) in the hydrocortisone group. The rates of resolution of triggering 3 months after injection were 22 of 28 (78.6%) in the triamcinolone group and 26 of 31 (83.9%) in the hydrocortisone group. In term of tenderness of A1 pulley, immediately after injection, absence of tenderness was documented in 26 of 34 patients (76.5%) in the triamcinolone group and in 28 of 36 patients (77.8%) in the hydrocortisone group. The rates of resolution of tenderness 3 months after injection were 18 of 28 (64.3%) in the triamcinolone group and 22 of 31 (71%) in the hydrocortisone group. There were no significant differences between Disabilities of the Arm, Shoulder, and Hand scores and Visual Analog Scale score for pain immediately after injection and the 3-month follow-up. After the close of the study, there was no complication in both treatment groups. CONCLUSIONS: There is no significant different in term of resolution of tenderness over A1 pulley, resolution triggering/locking, pain and physical disabilities score improvement between the two types of steroid injection. 2011 Thesis http://eprints.usm.my/38096/ http://eprints.usm.my/38096/1/Pages_from_Radzeli_Mohd_Ramli-RD701-811.pdf application/pdf en public masters Universiti Sains Malaysia Pusat Pengajian Sains Perubatan
institution	Universiti Sains Malaysia
collection	USM Institutional Repository
language	English
topic	RD701-811 Orthopedic surgery
spellingShingle	RD701-811 Orthopedic surgery Mohd Ramli, Radzeli Comparison between triamcinolone injection and hydrocortisone injection in treatment of trigger finger: a prospective single-blinded randomized controlled study
description	Trigger finger is a term for stenosing tenovaginitis affecting the excursion of the long flexor of the hand at the area of zone II of the digit. Steroid injection is one of the treatment option. Triamcinolone is the steroid mainly used for trigger finger treatment. Hydrocortisone is used only in paeditric trigger finger. Therefore result and outcome of hydrocortisone in treatment of adult trigger finger still not establish. PURPOSE: This study was designed to test the null hypothesis that there is no difference in resolution of trigger finger in term of pain, tenderness and triggering/locking in 3 months after injection with triamcinolone, a depot form of potent steroid or hydrocortisone, a highly soluble form but less potent steroid. METHODS: Seventy patients were enrolled in a prospective randomized controlled study comparing triamcinolone and hydrocortisone injection for idiopathic trigger finger. They were randomized into two groups; triamcinolone group and hydrocortisone group. All patients required to answer DASH questionnaire, give VAS score and evaluated for triggering/locking and tenderness at A1 pulley before injection, immediately after injection and 3 months after injection. Fifty-nine patients completed the 3 months follow-up (28 triamcinolone arm, 31 dexamethasone arm). Outcome measures included the Disabilities of the Arm, Shoulder, and Hand (DASH) questionnaire, presence/absence of triggering/locking finger, presence/absence of A1 pulley tenderness and pains severity base on visual analog scale. A Chi-square test and student t-test were used to compare both groups. RESULTS: Immediately after injection, absence of triggering was documented in 24 of 34 patients (70.6%) in the triamcinolone group and in 28 of 36 patients (77.8%) in the hydrocortisone group. The rates of resolution of triggering 3 months after injection were 22 of 28 (78.6%) in the triamcinolone group and 26 of 31 (83.9%) in the hydrocortisone group. In term of tenderness of A1 pulley, immediately after injection, absence of tenderness was documented in 26 of 34 patients (76.5%) in the triamcinolone group and in 28 of 36 patients (77.8%) in the hydrocortisone group. The rates of resolution of tenderness 3 months after injection were 18 of 28 (64.3%) in the triamcinolone group and 22 of 31 (71%) in the hydrocortisone group. There were no significant differences between Disabilities of the Arm, Shoulder, and Hand scores and Visual Analog Scale score for pain immediately after injection and the 3-month follow-up. After the close of the study, there was no complication in both treatment groups. CONCLUSIONS: There is no significant different in term of resolution of tenderness over A1 pulley, resolution triggering/locking, pain and physical disabilities score improvement between the two types of steroid injection.
format	Thesis
qualification_level	Master's degree
author	Mohd Ramli, Radzeli
author_facet	Mohd Ramli, Radzeli
author_sort	Mohd Ramli, Radzeli
title	Comparison between triamcinolone injection and hydrocortisone injection in treatment of trigger finger: a prospective single-blinded randomized controlled study
title_short	Comparison between triamcinolone injection and hydrocortisone injection in treatment of trigger finger: a prospective single-blinded randomized controlled study
title_full	Comparison between triamcinolone injection and hydrocortisone injection in treatment of trigger finger: a prospective single-blinded randomized controlled study
title_fullStr	Comparison between triamcinolone injection and hydrocortisone injection in treatment of trigger finger: a prospective single-blinded randomized controlled study
title_full_unstemmed	Comparison between triamcinolone injection and hydrocortisone injection in treatment of trigger finger: a prospective single-blinded randomized controlled study
title_sort	comparison between triamcinolone injection and hydrocortisone injection in treatment of trigger finger: a prospective single-blinded randomized controlled study
granting_institution	Universiti Sains Malaysia
granting_department	Pusat Pengajian Sains Perubatan
publishDate	2011
url	http://eprints.usm.my/38096/1/Pages_from_Radzeli_Mohd_Ramli-RD701-811.pdf
_version_	1747820682464460800

Comparison between triamcinolone injection and hydrocortisone injection in treatment of trigger finger: a prospective single-blinded randomized controlled study

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